腹腔镜手术治疗胰腺肿瘤的现状

Current status of laparoscopic surgery for pancreatic neoplasms

腹腔镜手术具有创伤小、康复快和不良反应少等优点。但在胰腺外科领域中，由于胰腺解剖位置深、周围结构复杂、吻合困难等因素，腹腔镜在胰腺的应用，远远落后于其他腹腔脏器手术。直到近年，腹腔镜胰腺手术还局限于胰腺癌腹腔探查、临床分期及姑息性短路等手术。术前常规或选择性行腹腔镜腹腔探查可避免不必要的剖腹探查带来的损害，降低并发症发生率，使晚期胰腺癌患者能及早康复并接受其他舒缓治疗。

Laparoscopic pancreatic surgery represents one of the most advanced applications for laparoscopic surgery currently in use. In the past, minimally invasive techniques in pancreatic surgery were only used for diagnostic laparoscopy, staging of pancreatic cancer and palliative procedures for unresectable pancreatic cancer. A growing number of case series and multi-institutional reports on safety and efficacy of minimally invasive pancreatic resection have been published. Current knowledge on minimally invasive pancreatic resection is based mainly on short-term outcomes from a small number of centers with cohorts too small to make strong arguments for or against its use. In carefully selected patients, minimally invasive pancreatic resection is safe and feasible. However, the procedure should only be attempted by surgeons who are experienced in open pancreatic surgery and in laparoscopic surgery. The role and oncologic safety of minimally invasive approach for pancreatic resection for pancreatic cancer remain unknown.