Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization: A case report (a CARE-compliant article)
Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization: A case report (a CARE-compliant article)
复制标题
3-D 可视化重建和门静脉动脉化辅助胰十二指肠切除术：病例报告（符合 CARE 标准的文章）
DOI：
10.1097/md.0000000000004697
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发表时间：
2016-09-01
期刊：
影响因子：
1.6
通讯作者：
Wang, Bo-liang
中科院分区：
文献类型：
--
作者：
Su, Zhao-jie;Li, Wen-gang;Wang, Bo-liang
背景：三维可视化重建（Three-dimensional visualization reconstruction）是利用二维CT图像通过软件重建的三维可视化模型，在医学上已得到广泛应用，但在胰腺切除术中应用较少。虽然肝动脉对肝脏非常重要，但当肿瘤侵犯肝脏时，必须切除肝动脉，因此，门静脉动脉化已被用作临床治疗措施，但门静脉动脉化仍存在争议。结果：初步诊断为十二指肠低分化腺癌和B型病毒性肝炎。在此病例中，施行了三维可视化重建辅助下的胰腺癌切除术和门静脉动脉化。肿瘤被切除了。术后1周肝功能恢复正常。结论：三维可视化重建可为胰腺切除术前准确评估和手术设计提供可靠的辅助，在无法保留肝动脉或需要常规动脉吻合的胰腺切除术中，门静脉动脉化是值得考虑的。
Background:Three-dimensional visualization reconstruction, the 3-D visualization model reconstructed by software using 2-D CT images, has been widely applied in medicine; but it has rarely been applied in pancreaticoduodenectomy. Although the hepatic artery is very important for the liver, it has to be removed when tumor invades it. Therefore, portal vein arterialization has been used in clinic as a remedial measure, but there still is professional debate on portal vein arterialization.Methods:Here, we report 1 case that was diagnosed with poorly differentiated adenocarcinoma of the duodenum. The tumor had large size and invaded surrounding organs and vessels.Results:Preliminary diagnoses were poorly differentiated adenocarcinoma of the duodenum and viral hepatitis B. Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization were performed in this case. The tumor was removed. Liver function returned to normal limits 1 week after operation. Digital subtraction arteriography showed compensatory artery branches within the liver 1 month after operation.Conclusion:3-D visualization reconstruction can provide a reliable assistance for the accurate assessment and surgical design before pancreatoduodenectomy, and it is certainly worth adopting portal vein arterialization when retention of hepatic artery is impossible or conventional arterial anastomosis is required during pancreatoduodenectomy.