腹腔镜或机器人辅助胰腺癌根治术中国专家共识(2022年版)

Chinese expert consensus on minimally invasive radical surgery for pancreatic ductal adenocarcinoma (version 2022)

尽管目前对于胰腺癌微创根治手术的疗效和安全性仍存在争议,但现有的多数研究结果均提示微创根治术具有广阔的应用前景。本共识参考中国专家意见和世界范围的研究结果,旨在探讨胰腺癌微创根治术的相关问题,以提高腹腔镜和机器人辅助胰腺癌根治术的围手术期安全和肿瘤学效果。这15项建议涵盖了5个主题:腹腔镜和机器人胰十二指肠切除术的肿瘤学结果和患者安全性、胰腺癌左侧胰腺切除术、学习曲线、新辅助治疗的安全性及胰腺癌微创根治术中的血管切除术,并根据推荐分级的评价、制定与评估方法评估其证据级别和推荐强度。这一共识为外科医师选择微创根治术治疗胰腺癌提供了参考和指导。虽然本共识不足以回答腹腔镜和机器人辅助胰腺癌根治术的所有问题,但代表了目前中国内地地区在胰腺癌治疗中应用这些技术的共识。

Although there are still controversies over the efficiency and safety of minimally invasive radical surgery for pancreatic ductal adenocarcinoma(PDAC),most available studies have suggested a promising application of minimally invasive radical surgery.This consensus,referring to Chinese expert opinions and worldwide researches,aimed to discuss the related issues on minimally invasive radical surgery for PDAC to ensure the perioperative and oncological outcomes.Quality of evidence and strength of recommendations were evaluated based on the GRADE approach.The 15 recommendations covered 5 topics:oncological outcomes and patient safety of laparoscopic and robotic pancreatoduodenectomy,left-side pancreatectomy for PDAC,learning curve,safety of neoadjuvant therapy,and vascular resection in minimally invasive radical surgery for PDAC.This consensus gives reference and guidance to surgeons on the use of minimally invasive radical surgery for PDAC.Although this consensus is not sufficient to answer all the questions about minimally invasive radical surgery for PDAC,it represents the current consensus on the application of the techniques in the treatment of PDAC on the Chinese mainland.