Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography
Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography
复制标题
DOI：
10.1016/j.amjsurg.2009.05.017
复制
发表时间：
2010-07-01
影响因子：
3
通讯作者：
Konno, Hiroyuki
中科院分区：
文献类型：
--
作者：
Sakaguchi, Takanori;Suzuki, Shohachi;Konno, Hiroyuki
背景：了解肠系膜静脉变异对胰周手术的实施非常重要。我们研究了三维（3-D）门静脉造影术的有用性。结果：102例胃肠道或肝胆胰外科手术患者中，上级肠系膜上静脉（SMV）在脾门静脉汇合处由单干和双干组成的分别有78例和24例。肠系膜下静脉与脾静脉、SMV和脾门静脉汇合处的汇合率分别为68.5%、18.5%和7.6%。胃左静脉与脾静脉、门静脉和脾门静脉汇合处的汇合率分别为46.3%、39.0%和14.7%。79例患者显示胃结肠干，主要由胃网膜右静脉和结肠肝曲静脉组成。68例胃切除术患者和9例胰腺切除术患者术中所见与3D诊断一致。结论：尽管肠系膜静脉属支复杂，但3D门静脉造影有助于外科医生安全地进行胰周手术。(C)2010年爱思唯尔公司All rights reserved.
BACKGROUND: It is important to be aware of mesenteric venous variants to perform peripancreatic surgery. We investigated the usefulness of 3-dimensional (3-D) portography.METHODS: Vessels. were reconstructed using computer software in 102 patients undergoing multidetector-now computed tomography (MDCT) scheduled for gastrointestinal or hepatobiliary-pancreatic surgery.RESULTS: The superior mesenteric vein (SMV) was composed of single and double trunks around the splenoportal confluence in 78 and 24 patients, respectively. The inferior mesenteric vein joined the splenic vein (68.5%), SMV (18.5%), and splenoportal confluence (7.6%). The left gastric vein joined the splenic vein (46.3%), portal vein (39.0%), and splenoportal confluence (14.7%). Seventy-nine patients showed a gastrocolic trunk, mostly composed of the right gastroepiploic vein and veins from the colonic hepatic flexure. Intraoperative findings were identical to 3-D diagnosis in 68 gastrectomized and 9 pancreatectomized patients.CONCLUSION: Although mesenteric venous tributaries are complex, 3-D portography is helpful for surgeons to safely perform peripancreatic surgery. (C) 2010 Elsevier Inc. All rights reserved.