左胰十二指肠切开术,切除猫的右胰叶和胰头。

Veterinary surgery : VS Pub Date : 2022-11-01 Epub Date: 2022-09-13 DOI:10.1111/vsu.13887
Benoît Cruciani, Chloé Touzet, Elisabeth Robin, Camille Bismuth
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引用次数: 1

摘要

目的:报道一种猫胰十二指肠切开术的手术方法及手术效果。动物:14岁的家猫。研究设计:病例报告。方法:一只猫因腹部大肿块转诊至我院。超声检查发现,肿块为一个充满液体的大腔,位于右胰管,并累及胰管和副胰管。左胰叶可见小回声腔。浆液从大腔中收集。细胞学检查显示,小腔符合脓肿。行左胰部分切除术以去除脓肿。切除了大腔,同时切除了右胰叶和体的残余。胰管结扎后,分离左侧胰管,行胰十二指肠端侧吻合。结果:猫康复无并发症。组织学检查符合慢性胰腺炎和周围性炎症。临床检查或实验室检查均未发现术后胰腺功能不全的证据。超声检查发现局灶性壶腹样胰管扩张,吻合处无其他并发症。术后225天出现呼吸窘迫。在x线片上发现整个肺实质有多发结节。超声检查异常包括肝脏肿大并浸润结节。由于预后不佳,猫被安乐死。最终组织病理学诊断为弥漫性癌。结论:胰十二指肠吻合术在胰管切除术后恢复了胰肠的连续性,并导致了猫的长期生存。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Left pancreaticoduodenostomy after removal of the right lobe and the head of the pancreas in a cat.

Objective: To report a surgical technique for pancreaticoduodenostomy and its outcomes in a cat.

Animals: A 14-year-old domestic cat.

Study design: Case report.

Methods: A cat was referred to our hospital with a large abdominal mass. On ultrasonographic examination, this mass was identified as a large fluid-filled cavity in place of the right pancreatic duct and involved the pancreatic and accessory pancreatic ducts. A small echoic cavity was observed in the left pancreatic lobe. Serous fluid was collected from the large cavity. On cytology, the small cavity was consistent with an abscess. A partial left pancreatectomy was performed to remove the abscess. The large cavity was excised with the remnant of the right pancreatic lobe and body. After ligation of the pancreatic ducts, the left pancreatic duct was isolated and an end-to-side pancreaticoduodenostomy was performed.

Results: The cat recovered without complications. Histological examination was consistent with chronic pancreatitis and peripheral inflammation. No evidence of postoperative pancreatic insufficiency was detected on clinical examination or laboratory findings. A focal ampulla-like dilation of the pancreatic duct was noted on ultrasonography, with no other complications at the anastomosis. The cat presented 225 days postoperatively with respiratory distress. Multiple nodules were identified throughout the lung parenchyma on radiographs. Abnormalities on ultrasonographic examination included an enlarged liver infiltrated with nodules. Due to poor prognosis, the cat was euthanized. Final histopathological diagnosis was diffuse carcinoma.

Conclusion: Pancreaticoduodenostomy restored pancreaticointestinal continuity after extensive pancreatectomy involving the pancreatic ducts and resulted in long-term survival in the cat reported here.

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