外科理论与实践

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2025 , Vol. 30 >Issue 06: 483 - 487

DOI: https://doi.org/10.16139/j.1007-9610.2025.06.05

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576例胰腺标准手术胰背动脉解剖分型及术中处理策略

  • 欧惠仪 ,
  • 金凯舟 ,
  • 叶龙云 ,
  • 吴伟顶
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  • 复旦大学附属肿瘤医院胰腺外科， 复旦大学上海医学院肿瘤学系，上海市胰腺肿瘤研究所，复旦大学胰腺肿瘤研究所， 上海 200032
吴伟顶，E-mail：wuweiding@fudanpci.org

收稿日期: 2025-11-04

  网络出版日期: 2026-01-26

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Anatomical classification and intraoperative management strategies of dorsal pancreatic artery in 576 standard pancreatic surgeries

  • OU Huiyi ,
  • JIN Kaizhou ,
  • YE Longyun ,
  • WU Weiding
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  • Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center； Department of Oncology, Shanghai Medical College, Fudan University； Shanghai Pancreatic Cancer Institute; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China

Received date: 2025-11-04

  Online published: 2026-01-26

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摘要

胰背动脉（DPA）是胰腺中研究最多的动脉之一。在胰腺标准切除/根治术（胰十二指肠切除/根治术、胰体尾联合脾脏切除/根治术、全胰切除/根治术）中DPA的处理与术后胰瘘腐蚀引起的晚期出血等并发症密切相关。本文收集团队于2024年8月—2025年7月内行开腹/微创胰腺标准切除/根治术病人的数据，展示了DPA的不同来源，讨论胰腺标准切除/根治术中对DPA的处理。本文更新完善DPA的最新分型，提出胰腺手术程序化处理DPA对降低术后晚期出血风险的重要性。

关键词： 胰腺标准切除/根治术; 胰背动脉; 来源

本文引用格式

欧惠仪 , 金凯舟 , 叶龙云 , 吴伟顶 . 576例胰腺标准手术胰背动脉解剖分型及术中处理策略[J]. 外科理论与实践, 2025 , 30(06) : 483 -487 . DOI: 10.16139/j.1007-9610.2025.06.05

Abstract

Dorsal pancreatic artery (DPA) is one of the most commonly studied arteries in the pancreas. The management of DPA during pancreatic standard resection/radical surgery (pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy) is closely related to complications such as late bleeding caused by pancreatic fistula erosion after surgery. This article collected data from patients who underwent open/minimally invasive standard pancreatic resection/radical surgery from August 2024 to July 2025, displayed different origins of DPA, and discussed the management of DPA during standard pancreatic resection/radical surgery. This article updated and improved the latest classification of DPA, and highlighted the importance of programmatic management of DPA in pancreatic surgery to reduce the risk of late postoperative bleeding.

Key words： Pancreatic standard resection/radical surgery; Dorsal pancreatic artery; Origination

参考文献

[1] TSUTSUMI M, ARAKAWA T, TERASHIMA T, et al. Morphological analysis of the branches of the dorsal pancreatic artery and their clinical significance[J]. Clin Anat, 2014, 27(4):645-652.
[2] 王子铭, 张志忠, 刘文生, 等. 腹腔镜胰十二指肠切除术中胰背动脉的解剖观察及处理[J]. 腹腔镜外科杂志, 2023, 28(10):733-738,753.
  WANG Z M, ZHANG Z Z, LIU W S, et al. The anatomic characteristics and management of the dorsal pancreatic artery in laparoscopic pancreatoduodenectomy[J]. J Laparosc Surg, 2023, 28(10):733-738,753.
[3] TRIANTAFYLLOU G, LYROS O, ARKADOPOULOS N, et al. The blood supply of the human pancreas: anatomical and surgical considerations[J]. J Clin Med, 2025, 14(16):5625.
[4] KYUNO T, MAKINO I, KITAGAWA H, et al. Morpho-logy of the dorsal pancreatic artery and its oncological significance in pancreatic cancer[J]. Pancreas, 2024, 53(6):e513-e520.
[5] CHERUIYOT I, CIROCCHI R, MUNGUTI J, et al. Surgical anatomy of the accessory middle colic artery: a meta-analysis with implications for splenic flexure cancer surgery[J]. Colorectal Dis, 2021, 23(7):1712-1720.
[6] 孙备, 李乐. 胰腺癌行标准与扩大的胰腺切除术定义与手术范围—2013国际胰腺外科研究组共识解读[J]. 中国实用外科杂志, 2015, 1:11-15.
  SUN B, LI L. The definition and excision extension of standard pancreatectomy and extended pancreatectomy-2013:interpretation of the international study group on pancreatic surgery by the consensus[J]. Chin J Pract Surg, 2015, 1:11-15.
[7] NGUYEN H H, NGUYEN T K, TRINH H S, et al. Feasibility of middle colic artery as a landmark for superior mesenteric artery - first approach in laparoscopic pancreatoduodenectomy: a prospective study[J]. World J Surg Oncol, 2024, 22(1):141.
[8] 林宇宁, 李辉, 杨熙章, 等. 糖尿病患者胰背动脉影像解剖的CTA与DSA对照研究[J]. 介入放射学杂志, 2011, 20(2):141-145.
  LIN Y N, LI H, YANG X Z, et al. Imaging anatomy of dorsal pancreatic artery in patients with diabetes: a comparative study between CTA and DSA[J]. J Interv Radiol, 2011, 20(2):141-145.
[9] 陆子鹏, 高鑫, 程浩, 等. 江苏省胰十二指肠切除手术情况和预后分析(附2 886例报告)[J]. 中华消化外科杂志, 2024, 23(5):685-693.
  LU Z P, GAO X, CHENG H, et al. Analysis of surgical situations and prognosis of pancreaticoduodenectomy in Jiangsu province (a report of 2 886 cases)[J]. Chin J Dig Surg, 2024, 23(5):685-693.
[10] WANG M, LI D, CHEN R, et al. Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours: a multicentre, open-label, randomised controlled trial[J]. Lancet Gastroenterol Hepatol, 2021, 6(6):438-447.
[11] MCMILLAN M T, ALLEGRINI V, ASBUN H J, et al. Incorporation of procedure-specific risk into the ACS-NSQIP surgical risk calculator improves the prediction of morbidity and mortality after pancreatoduodenectomy[J]. Ann Surg, 2017, 265(5):978-986.
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