Study On Applied Anatomy Of The Surgical Of The Superior Mesenteric Vein

Objective: We research the anatomical character of superior mesenteric vein's surgical department, clear about their left and right branches and the length of bore, provid the anatomical method for the relevant clinical treatment of portal hypertension. At the same time, it provides information for using the surgical department correctly.Method: We use 25 bodies with red emul perfusion and antisepsis fixation, then cut the epigastria zone up to xiphoid process, down to umbilical part. Open the skin by layers, subcutaneous tissue, the muscle of preabdomen, peritoneum. We pull the transverse colon above and flat it, reveal the end of transverse colon mesenterium,see the pars horizontalis duodeni clearly through posterior wall of abdomen. We cut the peritoneum of posterior wall at the left of pars horizontalis duodeni next to duodenojejunal flexure, reveal superior mesenteric vein, superior mesenteric artery, inferior vena cava, the third part of duodenum, measure the left and right branches of superior mesenteric vein, the form of Henle trunks, the length and bore of superior mesenteric vein, superior mesenteric vein's surgical department and inferior vena cava, the location of the third part of duodenum and it's connections, distance and so on. We use ruler, tape rule, vernier caliper (precision: 0.02mm) to measure the data, and then use the software of statistical analysis to treat these data. Then take photo for the important structure.Result: The surgical department has eight types. We can bypass, because the surgical department belong to the common type has enough length(2cm above).Each type has different variation, so it will affect the operation. But some surgical departments are short or disappearing and overlap between artery and vein, so they can't do shunting operation of the portal hypertension. The abouchement's types of right and left branches of superior mesenteric vein (jejunoileum vein) are very different, especially the composition and shape of Henle trunks. These differences must affect the shape of surgical department.(1)The height which Henle trunks inject to superior mesenteric vein determines the length of surgical department.(2)The left branch's shape connects with bore of surgical department. We find some information about the superior bore of surgical department: three branches>double branches>single branch, but the inferior bore of surgical department is opposition: single branch>double branches> three branches. Its bore of surgical department is constant in each type of branch. From this we find we can do the bypass of enteric cavity on middle of surgical department suitable. We should take care the inferior bore, because the type that has a lot of branches is exquisited gradually on bore.(3)The blood vessel stepping over the circa of the surgical department will affect the effect of splitting surgical department. We explain the middle part of surgical department is the safe part we do operation.(4) The connection between the surgical department and the third part of duodenum and the distance between the surgical department and inferior vena cava. The connection of location between the surgical department and the third part of duodenum affect the effect of Bridging vessel of enteric cavity shunting. Most of surgical department is above the third part of duodenum, seldom below it. We must take care of it. (5)The average distance between the surgical department and inferior vena cava is 33.1±1.2mm,so we cut the Bridging vessel in 40mm length.(6)We Summed up all anatomical factors. We find suitable surgical department fit the four terms by Holyoke and think about the connection of location between the surgical department and the third part of duodenum. The type of left and right branches of superior mesenteric vein determines length and bore of the surgical department.