门静脉回流、胰液肠内引流术式猪全胰十二指肠移植模型的建立

目的建立稳定的、符合生理的门静脉回流、空肠内引流术式猪全胰十二指肠移植模型。方法40头四川本地杂种猪分为供、受体两组(n=20)。采用UW液低温灌注的方法，整块切取供体全胰十二指肠，保留腹主动脉Carrel片和门静脉。UW液保存、修整后的胰腺十二指肠移植物用髂血管延长的动脉与供体腹主动脉段端-侧吻合；门静脉与供体肠系膜上静脉端-侧吻合；十二指肠与供体空肠侧-侧吻合。结果共完成猪全胰十二指肠移植手术20例。胰腺移植术后1例因麻醉过深，呼吸抑制而术后未能复苏；1例移植胰腺血栓形成、血管栓塞；另1例死于肠瘘导致的腹腔感染。17例术后第2天检测外周血血糖正常。结论猪全胰十二指肠移植门静脉回流、空肠内引流术式大动物模型稳定、可靠。

Establishment of whole pancreatico-duodenal allotransplantation model with portal venous drainage and enteric drainage in pigs

Objective To establish the model of whole pancreaticoduodenal transplantation with portal venous drainage and enteric drainage in the pigs.Methods Forty outbred white pigs were divided into two groups (n=20 in each) randomly.A whole pancreatoduodenal graft was harvested with a arterial Carrel patch containing the celiac artery and the superior mesenteric artery and the portal vein.The whole pancreatoduodenal graft was preserved and shaped in UW solution,and its artery which prolonged by the donor's common iliac artery.The Y-shaped bifurcation was coincided with the segment of abdominal aorta.The venous reflu was reconstructed between the donor's portal vein and the recipient's superior mesenteric vein.The side-to-side intestinal anastomosis was performed between donor's duodenum and recipient's jejunum.Results Twenty cases of pancreaticoduodenal transplantation (PVE+ED style) were done,in which 1 case died from respiratory depression because of anesthesia,and 1 case's pancreatic graft had thrombosis and embolism on the 5th day after transplantation.Another one was died unexpectedly on the 3th day due to the infection in abdominal cavity caused by intestinal fistula.The blood sugar was normal in peripheral blood on the postoperative 2nd day.Conclusion The model of the whole pancreaticoduodenal transplantation with portal venous drainage and enteric drainage is stable and reliable.