据报道,胰腺的各种先天性异常是由于其复杂的胚胎发育,涉及两个独立芽的融合。门静脉周围胰腺是一种罕见的解剖异常,胰头和钩突与胰体异常融合,完全包裹门静脉和/或肠系膜上静脉。这种异常对肝胆外科医生提出了一些挑战,由于异常胰腺组织包裹门静脉,因此需要进行额外的实质横切。据报道,门静脉周围胰腺也有血管变异,which,如果术前没有确认,可能是灾难性的。因此,仔细的术前评估和计划至关重要,以确保安全的胰腺切除和复苏患者的门静脉环行胰腺。我们介绍了一个成功的胰腺次全切除术和脾切除术的病例。疑似胰管腺癌.本病例报告的目的是提供有价值的见解,以帮助肝胆外科医生在遇到具有相似解剖差异的患者时增强术前计划。
Various congenital anomalies of the pancreas have been reported due to its complex embryological development involving the fusion of two separate buds. Circumportal pancreas is a rare anatomical anomaly where the pancreatic head and uncinate process fuse abnormally with the pancreatic body, encasing the portal vein and/or superior mesenteric vein completely. This anomaly poses several challenges to hepatobiliary surgeons, as the encasement of the portal vein by the abnormal pancreatic tissue makes an additional parenchymal transection necessary. Vascular variants have also been reported with circumportal pancreas, which, if not recognised preoperatively, can be catastrophic. Therefore, careful preoperative evaluation and planning are essential, to ensure safe pancreatic resection and recovery in a patient with circumportal pancreas. We present a case of a successful subtotal pancreatectomy and splenectomy in a patient with circumportal pancreas, for a suspected pancreatic duct adenocarcinoma. The aim of this case report is to contribute valuable insights that can aid hepatobiliary surgeons in enhancing their preoperative planning when encountered with patients with similar anatomical variances.