胰腺手术中自体组织的应用

Application of autologous tissue in pancreatic surgery

胰腺手术难度大,术后并发症发生率高,对病人生活质量影响大。自体组织在胰腺手术中被广泛运用,对降低胰腺术后并发症发生率和提高病人生活质量具有重要意义。自体组织在胰腺手术中的运用主要包括自体血管移植、韧带及网膜的应用和自体胰岛细胞移植等。血管重建过程中自体组织被认为是首选的血管移植物,但目前关于最佳移植物选择尚未达成共识。肝圆韧带、大网膜的应用和胰体尾切除术中胰腺残端后腹膜化可在一定程度上降低术后并发症发生率,但仍存争议。自体胰岛细胞移植在改善病人术后血糖控制和术后生活质量方面发挥了积极作用。但关于自体组织应用的研究多为单中心回顾性研究,未来需要多中心、大样本量的前瞻性研究证实其价值。

Pancreatic surgery is challenging with high incidence of postoperative complications and greatly affected postoperative quality of life.Autologous tissue has been widely used in pancreatic surgery,which is of great significance in reducing the incidence of postoperative complications and improving the quality of life.The application of autologous tissue in pancreatic surgery mainly includes autologous vessel transplantation,the application of ligaments and greater omentum,autologous islet cell transplantation,and so on.Autogenous tissue is considered to be the preferred vascular graft during vascular reconstruction,but there is no consensus on the optimal graft selection.It is still controversial that the application of ligamentum teres hepatis,greater omentum and retroperitonealization of pancreatic stump in distal pancreatectomy could reduce the incidence of postoperative complications to some extent.Autologous islet cell transplantation plays a positive role in improving postoperative blood glucose control and postoperative quality of life.However,most of the studies on the application of autologous tissue are single-center retrospective studies,which means more multi-center prospective studies with large sample size are needed to confirm its value in the future.