保留十二指肠的胰头切除术的临床及微创应用进展  

Advances in clinical and minimally invasive applications of duodenum-preserving pancreatic head resection

作　　者：刘颂 卢杏生[1] LIU Song;LU Xingsheng(Dushu Lake Hospital Affiliated to Soochow University,Suzhou,Jiangsu 215000,P.R.China)

机构地区：[1]苏州大学附属独墅湖医院普外科,江苏苏州215000

出　　处：《中国普外基础与临床杂志》2023年第11期1395-1401,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：2022年度苏州市临床重点病种诊疗技术专项(项目编号:LCZX202235)。

摘　　要：目的 探讨保留十二指肠的胰头切除术(duodenum-preserving pancreatic head resection,DPPHR)在胰腺外科疾病临床应用中的优势及不足,并结合目前腹腔镜及机器人手术在胰腺外科的应用,总结DPPHR的微创应用进展。方法 检索近年国内外有关DPPHR相关研究文献并进行综述。结果 DPPHR相较于传统的胰十二指肠切除术(pancreaticoduodenectomy,PD)来说,对胰腺良性疾病的治疗效果仍存有较大争议,在术后的症状缓解效果、围手术期和远期并发症的发生以及生活质量的提升方面与PD相比优势不明显,并且其微创应用的效果欠佳。结论 DPPHR对胰腺良性疾病的外科干预仍然存在较大争议,在胰腺外科微创手术应用方面具有巨大的发展空间,但尚需更多的临床研究验证其临床疗效。Objective To explore the advantages and disadvantages of duodenum-preserving pancreatic head resection(DPPHR)in the clinical application of pancreatic surgical diseases,and to summarize the progress of minimally invasive application of DPPHR combined with the current application of laparoscopy and robot surgery in pancreatic surgery.Method The related research literatures about DPPHR at home and abroad in recent years were searched and reviewed.Results The effect of DPPHR compared with traditional pancreaticoduodenectomy(PD)for treatment of benign pancreatic diseases was still controversial,and the postoperative remission effect,perioperative period,occurrence of long-term complications and improvement of quality of life were not very advantageous compared with PD,and the prognosis of minimally invasive surgery was poor.Conclusion DPPHR remains highly controversial for surgical intervention in benign pancreatic disease and has enormous scope for advances in minimally invasive surgical applications in pancreatic surgery,but more clinical studies are needed to verify its clinical efficacy.

关 键 词：保留十二指肠的胰头切除术 胰腺良性疾病 慢性胰腺炎 胰头良性肿瘤 胰腺微创外科 

分 类 号：R657.5[医药卫生—外科学]