Microanatomy of the carunculae major artery and its clinical significance
Chinese Journal of Clinical Anatomy ›› 2015, Vol. 33 ›› Issue (3) : 262-264.
Microanatomy of the carunculae major artery and its clinical significance
Objective To provide exact and reliable morphological data for the operation of endoscopic sphincterotomy (EST). Method (1) 20 cadeveric duodenum and pancreas were perfused with latex. (2)The resource, number, diameter, branches of all carunculae major arteries of these specimens and the distance from vascular origin to Vater bulb, the inner margin of duodenum and carunculae major were observed. Results (1) Carunculae major arteries originated from the anterior and posterior arterial arches, and each had two branches. The diameter of the two branches of the anterior carunculae major artery was (1.3±0.1) mm and (1.0±0.2) mm. The distance from the vascular origin of the two branches to the Vater’s ampulla, the inner margin of duodenum and carunculae major was (5.7±0.6) mm and (6.0±0.4) mm, (8.7±1.1) mm and (9.7±1.7) mm, (16±0.9) mm and (16±1.5) mm, respectively. The diameter of the two branches of the posterior carunculae major artery was (0.62±0.02) mm and (0.98±0.06) mm. The distance from the vascular origin of the two branches to Vater’s ampulla, the inner margin of duodenum and carunculae major were (11±0.7) mm and (16.4±0.4) mm ,(13±0.3) mm and (17.9±0.3) mm, (16±0.7) mm and (19.2±0.6) mm, respectively. (2) The first branch of the anterior carunculae major arteries was at the direction 10~11 o'clock and the second branch was at the position 2~3 o'clock. The first branch of the posterior carunculae major arteries was at the position of 8~9 o'clock and the second branch was at the position of 4~5 o'clock. The branches of carunculae major arteries were primarily located at the position of 8~11 o'clock and secondarily at the position of 2~5 o'clock, and least at 11~1 as well as 6~7 o'clock. Conclusion In EST the incision should be made at the direction of 11~1 or 6~7 o'clock.
[1] 陆兆炯,刘福建,杨军雄,等.经内镜下治疗胆总管结石100例临床分析[J].中国实用医药,2011,35(6):99-100.
[2] 樊晓静,段绍斌,居来提.艾力,等.内镜技术在胆囊结石及胆总管结石手术中的应用[J].山东大学学报,2011,49(8):118-120.
[3] 顾 红,田 雨,李 会,等.EST治疗胆总管结石与开腹胆总管切开取石术“T”管引流的对照观察[J].贵州医药,2010,34(8):712-713.
[4] 单深良,梁华钦,欧 希,等.内镜下乳头球囊扩张术在胆总管结石治疗中的应用[J].医学综述,2012,18(17):2863-2865.
[5] 姚礼庆,张 波,高卫东,等.经内镜乳头气囊扩张术治疗胆总管结石[J].中华消化内镜杂志,1999,16(5):80.
[6] 王钦尧.胆胰十二指肠区域-临床外科学[M].上海:上海科学技术出版社,2006:1-2.
[7] 汪坤菊,陈 敏,石小田,等.内窥镜十二指肠大乳头取结石术的动脉应用解剖[J].解剖学杂志,2013,36(6):1017-1019.
[8] 傅群武,丁自海,吴 涛,胰头的动脉分布及其临床意义[J].中国临床解剖学杂志,2005,23(6):631-634.
[9] 孙庆峰,韩德恩,李玉兰,等.胰头十二指肠区域血管的应用解剖学研究[J].哈尔滨医科大学学报,2003,37(5):409-411.
/
〈 |
|
〉 |