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中国实用外科杂志 2014年第3期34卷 279-280页

作者：徐宪辉张勤林森金钢中国人民解放军第401医院普外科山东青岛266071 第二军医大学长海医院普三科上海200433

胰十二指肠切除术手术复杂，切除及清扫范围广，术中门静脉、肠系膜上静脉及其属支（胃结肠干、空肠第一静脉）的损伤严重影响手术顺利完成，术中静脉损伤出血甚至会威胁病人的生命。如何避免血管损伤、减少术中出血，是顺利地完成胰十... 详细信息

胰十二指肠切除术手术复杂，切除及清扫范围广，术中门静脉、肠系膜上静脉及其属支（胃结肠干、空肠第一静脉）的损伤严重影响手术顺利完成，术中静脉损伤出血甚至会威胁病人的生命。如何避免血管损伤、减少术中出血，是顺利地完成胰十二指肠切除术和保证围手术期安全的重要前提。本文就胰十二指肠切除术中门／肠静脉出血的预防与止血问题做一讨论。

关键词：胰十二指肠切除术静脉出血门肠静脉

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Establishment of a pig model with enteric and portal venous drainage of pancreatoduodenal transplantation

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World Journal of Gastroenterology 2005年第35期11卷 5475-5479页

作者： Zhao-Da Zhang Fang-Hai Han Ling-Xiang Meng Third GeneralDepartment West China Hospital of Sichuan University Chengdu610041 Sichuan Province China

AIM: To establish the pig model of pancreatoduodenal transplantation with enteric drainage (ED) and portal venous drainage (PVD).METHODS: Forty-six hybrid Landrace pigs were divided into two groups (donors and recipients) randomly, and pancreatoduodenal allotransplantation was performed.Donors were perfused via abdominal aorta without clamping the portal venous outflow with UW solution at 80-100 cm H2O after heparinization. Whole pancreatoduodenal grafts were harvested with segments of abdominal aorta and portal vein, and shaped under 4 ℃ UW solution. Then, end-to-end anastomosis was performed with the donor iliac artery bifurcation Y graft to the recipient superior mesenteric artery and celiac artery. Furthermore, type Ⅰ diabetes model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesentery vein. Meanwhile, end-toside anastomosis was performed with the donor common iliac artery bifurcation Y graft to the recipient abdominal aorta, and side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. Levels of plasma glucose, insulin and glucagon were measured during the operation and on the 1st, 3rd, 5th, and 7th d after operation.RESULTS: Pancreatoduodenal allotransplantation was performed on 23 pigs of which 1 died of complication of anesthesia. The success rate of operation was 95.6%.Complications of operation occurred in two cases in which one was phlebothrombosis with an incidence of 4.6%,and the other was duodenojejunal anastomotic leak with an incidence of 4.6%. The level of plasma glucose decreased within 30 min, after removal of pancreas and recovered on the 2nd d after operation. The level of plasma insulin and glucagon increased within 30 min after removal of pancreas and recovered on the 2nd d after operation.Rejection occurred on the 1st d and reached the worst level on the 7th d after transplantation, without ch

关键词：猪动物实验肠静脉肠移植胰腺损伤并发症

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