胰管(修复)外科概述与思考

Overviews and reflections on pancreatic duct(repair)surgery

毗邻主胰管的胰腺良性肿瘤及交界性肿瘤,因其手术剜除时易损伤主胰管而通常选择扩大切除范围,并进行消化道的改建,这种扩大性的手术方式造成过多的医源性损伤,破坏了胰腺正常解剖结构和消化道连续性,不利于病人的预后。随着外科微创理念和医疗技术的不断进步,作者在总结大量机器人胰腺手术经验的基础上,提出了以主胰管架桥修复为核心的胰管(修复)外科的概念,并在临床应用中总结提出了相关的一系列思考。胰管(修复)外科概念的提出与发展有望实现胰腺良性及交界性肿瘤的治疗创伤最小化,以期预后最佳化。

For benign tumors and borderline tumors of pancreas adjacent to main pancreatic duct,surgeons often opt to expand the resection range and perform digestive tract reconstruction for minimizing the risk of compromising main pancreatic duct during surgical enucleation.This expanded surgical approach causes excessive iatrogenic injuries so as to disrupt normal anatomical structure of pancreas and impairs the continuity of digestive tract.It is not conducive to patient outcomes.There are continuous advancements of mini-invasive surgical concepts and medical technology.Drawing upon extensive experiences of robotic pancreatic surgery,the authors proposed the concept of pancreatic duct(repair)surgery with a core of main pancreatic duct bridging repair.The goal was to achieve minimal trauma and obtain optimal outcomes for benign and borderline pancreatic tumors.