加速康复外科在胰十二指肠切除术中的应用进展

Progress of application for enhanced recovery after surgery in pancreaticoduodenectomy

胰十二指肠切除术（PD）因手术创伤大、术后并发症多,其围手术期处理一直是外科医师亟待解决的难题之一.随着现代医学日新月异,基于“抗应激机制”及“多学科协作”的加速康复外科（ERAS）应运而生,使得PD围手术期处理不断得到优化及改善.外科医师通过综合运用基于现有循证医学证据的优化措施,以降低患者对手术创伤的应激反应,减少患者术后并发症的发生,缩短住院周期,实现患者获益最大化.目前有关ERAS应用于PD的具体环节仍存在争议之处.但随着循证医学的兴起,ERAS也将会不断得到完善.因此,结合ERAS指南及专家共识,进一步加深ERAS在PD的研究及理解具有重要意义.

Due to the large surgical trauma and postoperative complications,the perioperative management of pancreaticoduodenectomy has been one of the urgent problems to be solved by the surgeons.With the development of modern medicine,enhanced recovery after surgery （ERAS） comes into being,basing on anti-stress mechanism and multi-disciplinary team,and the perioperative management of pancreaticoduodenectomy has been optimized and improved continuously.The surgeons through a range of measures that had evidence-based medicine basis to mitigate the extent of surgical trauma stress,reduce the incidence of postoperative complications,shorten patient recovery time previously healthy state,and achieve maximize benefit for patients.Currently,the ERAS application in the specific aspects of pancreaticoduodenectomy remains contentious.However,with the emergence of evidence-based medicine,ERAS is constantly being refined.Therefore,this article combined with ERAS guidelines and expert consensus is of great significance to deepen the research and understanding of ERAS in pancreaticoduodenectomy.