2024版NCCN指南中胰腺癌外科治疗部分解读

Interpretation of the surgical treatment of pancreatic cancer of the 2024 edition of the NCCN guidelines

胰腺癌是消化系统恶性程度较高的肿瘤,根治性手术是目前唯一可能治愈胰腺癌的手段。近十年来,胰腺外科发展迅速,各类新技术、新理念不断涌现,其中以微创技术的运用和新辅助治疗理念的普及最为引人注目;同时,胰腺癌的外科治疗仍有很长的道路要走,许多问题亟待解决。本文对2024版NCCN指南中胰腺癌外科治疗部分进行介绍,重点解读微创入路和开腹手术治疗、扩大淋巴结清扫、联合血管切除重建、胰颈癌的手术治疗和新辅助治疗这几方面,同时对其中尚未解决的问题做简要讨论。

Pancreatic cancer is a highly malignant tumor in the digestive system,and radical surgery is the only possible means to cure pancreatic cancer at present.In the past decade,pancreatic surgery has been developing rapidly,with various new technologies and concepts emerging,among which the use of minimally invasive techniques and the popularization of neoadjuvant therapy concepts are the most notable.At the same time,the surgical treatment of pancreatic cancer still has a long way to go,and many problems need to be solved urgently.This article introduces the surgical treatment of pancreatic cancer in the 2024 edition of the NCCN guidelines,focusing on minimally invasive and open surgical treatments,expanded lymph node dissection,combined vascular resection and reconstruction,surgical treatment of pancreatic neck cancer and neoadjuvant therapy,and briefly discussing the unresolved issues.