以主胰管处理为导向对若干胰腺术式的探讨

A study on several surgical methods of pancreas guided by main pancreatic duct treatment

随着腹腔镜和机器人技术的逐渐普及,胰腺手术正朝着减少并发症、保留更多胰腺功能的方向发展。主胰管是胰腺外分泌液的重要流出通道,精准处理主胰管可有效降低胰腺术后并发症的发生率。本文围绕胰肠吻合、胰腺远端切除、胰腺假性囊肿与主胰管的关系及胰腺部分切除术等难点,重点介绍腹腔镜和机器人技术下常见胰腺术式中主胰管的处理方法。同时,提出"胰管黏膜对黏膜六针法"进行胰腺中段切除、端端吻合的手术方式,利用微创技术达到最佳手术效果,让更多患者获益。

With the gradual spread of laparoscopic and robotic technology,pancreatic surgery is developing toward reducing complications and preserving more pancreatic functions.The main pancreatic duct is an important outflow channel for pancreatic exocrine fluid,and precise management of the main pancreatic duct can effectively reduce the occurrence of postoperative pancreatic complications.This paper focuses on the difficulties of pancreatic-intestinal anastomosis,distal pancreatic resection,the relationship between the pancreatic pseudocyst and main pancreatic duct,and partial pancreatic resection,and introduces how to properly manage the main pancreatic duct in common pancreatic procedures under laparoscopic and robotic techniques.Besides,the“mucosa-to-mucosa six-stitch method”for mid-pancreatic resection and end-to-end anastomosis has been proposed,which can achieve the best surgical results with minimally invasive technology and benefit more patients.