功能保护理念下的胰腺疾病外科诊治进展

Recent advances in surgical diagnosis and treatment of pancreatic diseases under the concept of functional protection

胰腺手术是治疗重症急性胰腺炎、慢性胰腺炎和胰腺良、恶性肿瘤的重要手段之一。传统的胰腺手术切除了大量正常的胰腺组织,建立复杂的消化道重建,手术创伤大。胰腺作为重要的内、外分泌器官,术后胰腺功能的丧失,严重影响病人的生活和生存质量。因此,为改善病人预后,保留器官功能的胰腺切除手术和“Step-up”升阶梯治疗模式成为目前研究热点。目前常用的保留功能的胰腺术式包括:保留幽门的胰头十二指肠切除术、保留十二指肠的胰头切除术、胰腺肿瘤剜除术和中段胰腺切除术。该文就保留器官功能胰腺切除术的研究现状及术式选择做一综述。

Pancreatic surgery is vital for treating acute severe pancreatitis,chronic pancreatitis and benign/malignant pancreatic tumors.Traditional pancreatic surgery removes a large amount of normal pancreatic tissue so that reconstructing digestive tract is rather complicated.As an important endocrine organ,postoperative loss of pancreatic function may seriously affect the quality-of-life and survival of patients.For a better prognosis,pancreatic resection with preserved organ function and"Step-up"treatment model have become hot research topics.Currently function-preserving pancreatic procedures include pylorus preserving pancreatic head-duodenectomy,duodenum preserving pancreatic head resection,pancreatic tumor enucleation and central pancreatectomy.This review summarized the latest researches of organ function preserving pancreatectomy and selecting procedures.