摘要
随着外科技术水平的提高和对解剖认知的深入,精准外科理念逐步发展,传统大范围联合器官切除治疗良性及交界性肿瘤因较高的远期并发症风险,其必要性面临挑战。以保留十二指肠的胰头切除术为代表,40年来不断有各种改良术式出现,手术指征逐步从慢性胰腺炎过渡到胰头部良性及交界性肿瘤;切除范围也从胰头大部切除、次全切除向胰头全切除转变;手术方式从既往单纯开放手术转变到目前腹腔镜或机器人辅助等微创入路术式,体现出治疗理念、手术方式的更新与优化。本文对保留十二指肠的胰头切除术的发展历程、手术指征及其相关并发症予以论述,以期为临床中更规范、合理地选择该术式提供参考,同时降低并发症发生率。
With the improvement of surgical techniques and deeper anatomical understanding,the concept of precision surgery has gradually developed.The necessity of traditional extensive organ resection for the treatment of benign and borderline tumors is being challenged due to the high risk of long-term complications.Over the past 40 years,various modified surgical techniques have emerged,with duodenum-preserving pancreatic head resection as a representative procedure.The surgical indications have gradually transitioned from chronic pancreatitis to benign and borderline tumors of the pancreatic head.The extent of resection has evolved from major partial resection and subtotal resection to total resection of the pancreatic head.The surgical approach has also progressed from traditional open surgery to minimally invasive techniques such as laparoscopic or robot-assisted surgery,reflecting updates and optimizations in treatment concepts and surgical methods.This paper discusses the development,surgical indications,and related complications of duodenum-preserving pancreatic head resection.The aim is to provide a reference for the more standardized and rational selection of this surgical procedure in clinical practice while reducing the incidence of complications.
作者
陈依然
田孝东
杨尹默
Chen Yiran;Tian Xiaodong;Yang Yinmo(Department of Hepatobiliary&Pancreatic Surgery,Peking University First Hospital,Beijing 100034,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2024年第10期913-917,共5页
Chinese Journal of Surgery
基金
国家自然科学基金(82171722,82271764,81871954)
北京市自然科学基金(7212111)。
关键词
胰腺肿瘤
外科手术
慢性胰腺炎
保留十二指肠的胰头切除术
Pancreatic neoplasms
Surgical procedures,operative
Chronic pancreatitis
Duodenum-preserving pancreas head resection
