胰头区血供的临床应用解剖学研究
发布时间：2018-07-23 20:00
【摘要】：目的:为传统胰头与十二指肠的切除术和腹腔镜胰头十二指肠切除术提供应用解剖学依据。 方法:(1)动脉灌注红色乳胶的防腐尸体20具,观测胰头周围毗邻;(2)从全部20例标本中连同十二指肠和脾取出全胰,重点研究胰头区的血供;(3)在离体标本中选取9例胰头标本进行胰头内部血供的研究;(4)胰头十二指肠动脉铸型标本5例,与尸体标本对照研究胰头区及胰头内部的血供规律;(5)进行腹腔动脉和肠系膜上动脉造影,显示两动脉之间在胰头区的吻合及血供分布,进行对比研究。 结果:(1)胰头的毗邻:①胰头前面由浅至深依次为胃、网膜囊和横结肠系膜所覆盖;②后面走行有下腔静脉、右肾静脉和胆总管,其中胆总管可在胰头后表面或实质中穿行;③左侧与肠系膜上动、静脉相毗邻,并伴行有迷走神经腹腔支;④上方紧邻腹腔干其分支肝总动脉;⑤右上角紧邻胃幽门窦和十二指肠上部,胃十二指肠血管经两者之间的间沟向下走行;⑥下面为十二指肠水平部包绕。(2)胰头十二指肠区的血供:①血供十分丰富,分别来自腹腔干和肠系膜上动脉的分支在两者前后均形成动脉弓,营养胰头部的动脉也是十二指肠的主要血供来源。②前动脉弓有2种变异;它与十二指肠的距离在前上动脉发出处为18.0mm,在大乳头下1.47cm处转入间沟中,在与胰头右侧缘交角处为12.0mm;前动脉弓在走行中向外发出12条分支到十二指肠前壁,向内发出4条分支到胰头内部;③胰
[Abstract]:Objective: to provide anatomic basis for traditional and laparoscopic pancreaticoduodenectomy. Methods: (1) 20 embalmed cadavers with red latex infused by artery were observed adjacent to the head of pancreas, and (2) the whole pancreas was removed from all 20 specimens, including duodenum and spleen. The study focused on the blood supply of the pancreatic head region; (3) the study of the internal blood supply of the pancreatic head in 9 cases of isolated specimens; (4) the study of the blood supply of the duodenal artery of the head of the pancreas in 5 cases; Compared with the cadaveric specimens, the blood supply of the head of pancreas and the interior of the head of pancreas were studied. (5) the celiac artery and the superior mesenteric artery were performed to show the anastomosis and blood supply distribution between the two arteries in the pancreatic head area. Results: (1) from superficial to deep in front of head of pancreas, there were inferior vena cava, right renal vein and common bile duct. The common bile duct could pass through the posterior surface or parenchyma of pancreatic head. (3) the left side was adjacent to the superior mesenteric artery and vein and was accompanied by the vagus nerve, the abdominal branch of the vagus and the superior corner of the common hepatic artery, which was adjacent to the gastric pyloric sinus and the upper part of the duodenum, in the upper corner of the common hepatic artery, which was a branch of the celiac trunk. The gastroduodenal vessels go downwards through the sulcus between them. (2) the blood supply of the duodenal region of the pancreatic head and the duodenum is very abundant. The branches from the celiac trunk and superior mesenteric artery formed the arterial arch before and after, and the artery of the head of the pancreas was also the main blood supply source of the duodenum, and there were two variations in the arch of the anterior artery of the duodenum. The distance from the duodenum to the duodenum is 18.0 mm at the origin of the anterior superior artery, 12.0 mm at the angle with the right margin of the head of the pancreas into the intersecting sulcus at the 1.47cm under the great papilla, and 12 branches outward from the arch of the anterior artery to the anterior wall of the duodenum. 4 branches to the inside of the head of the pancreas
【学位授予单位】：第一军医大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R322
本文编号：2140490
[Abstract]:Objective: to provide anatomic basis for traditional and laparoscopic pancreaticoduodenectomy. Methods: (1) 20 embalmed cadavers with red latex infused by artery were observed adjacent to the head of pancreas, and (2) the whole pancreas was removed from all 20 specimens, including duodenum and spleen. The study focused on the blood supply of the pancreatic head region; (3) the study of the internal blood supply of the pancreatic head in 9 cases of isolated specimens; (4) the study of the blood supply of the duodenal artery of the head of the pancreas in 5 cases; Compared with the cadaveric specimens, the blood supply of the head of pancreas and the interior of the head of pancreas were studied. (5) the celiac artery and the superior mesenteric artery were performed to show the anastomosis and blood supply distribution between the two arteries in the pancreatic head area. Results: (1) from superficial to deep in front of head of pancreas, there were inferior vena cava, right renal vein and common bile duct. The common bile duct could pass through the posterior surface or parenchyma of pancreatic head. (3) the left side was adjacent to the superior mesenteric artery and vein and was accompanied by the vagus nerve, the abdominal branch of the vagus and the superior corner of the common hepatic artery, which was adjacent to the gastric pyloric sinus and the upper part of the duodenum, in the upper corner of the common hepatic artery, which was a branch of the celiac trunk. The gastroduodenal vessels go downwards through the sulcus between them. (2) the blood supply of the duodenal region of the pancreatic head and the duodenum is very abundant. The branches from the celiac trunk and superior mesenteric artery formed the arterial arch before and after, and the artery of the head of the pancreas was also the main blood supply source of the duodenum, and there were two variations in the arch of the anterior artery of the duodenum. The distance from the duodenum to the duodenum is 18.0 mm at the origin of the anterior superior artery, 12.0 mm at the angle with the right margin of the head of the pancreas into the intersecting sulcus at the 1.47cm under the great papilla, and 12 branches outward from the arch of the anterior artery to the anterior wall of the duodenum. 4 branches to the inside of the head of the pancreas
【学位授予单位】：第一军医大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R322
【引证文献】
相关硕士学位论文 前1条
1 王华;胰十二指肠区火棉胶包埋薄型化断层的应用解剖学研究[D];天津医科大学;2010年
，本文编号：2140490
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