关键词: 腹腔镜, 胰十二指肠切除术, 肠系膜上动脉, 应用解剖, 外科平面

Abstract: 【Abstract】〓Objective〓To invesgate regional anatomy features of related vessels and surgical planes in posterior approach laparoscopic pancreaticoduodenectomy (paLPD). Methods〓In order to distinguish related vessels in paLPD accurately, we explored anatomy symbols, exposure methods and search for safe surgical planes under laparoscopic visions by means of analysis from 25 patients surgery videos and observing anatomy features of 15 adult specimens. Results〓Four regions are identified as important surgical planes in paLPD,including the avascular region between posterior pancreas duodenum and prerenal fascia,the avascular region between posterior pancreatic neck and superior mesenteric vein, the region between pancreatic uncinate process and mesenteric vessels, and the celiac trunk and hepatoduodenal ligament regions,and they cover all related vessels in paLPD. Operating along accurate surgical planes,we can not only reduce vessels injury risks,but also improve surgery efficiency and follow the “en bloc” principle better. Conclusion〓paPLD is a safety and feasible way in LPD,and we can improve surgery safety and efficiency by mastering the features of related vessels under laparoscopic visions and operating along accurate surgical planes.

Key words: Laparoscopy, Pancreaticoduodenectomy, Superior mesenteric artery, Applied anatomy, Surgical plane