精准外科理念在胆囊癌治疗中的应用  

The application of precision surgery in the treatment of gallbladder cancer

作　　者：董家鸿[1] 项灿宏[1] 白志清 DONG Jia-hong;XIANG Can-hong;BAI Zhi-qing(Department of Hepatopancreatobiliary Center,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院-肝胆胰中心,中国医学科学院精准肝胆外科范式创新单元,清华大学临床医学院数智肝胆病学教育部重点实验室,北京102218

出　　处：《中国实用外科杂志》2023年第11期1201-1207,共7页Chinese Journal of Practical Surgery

基　　金：中国医学科学院医学与健康科技创新工程创新单元项目(No.2019-I2M-5-056);国家自然科学基金重点项目(No.81930119)。

摘　　要：胆囊癌恶性程度高,预后差,是常见的消化系统恶性肿瘤之一。目前,胆囊癌临床实践在侵袭转移范围及微转移灶判定、手术切除范围、非手术治疗方案和时机选择等方面仍存在诸多不确定性,需要精准外科理念对其加以优化。精准外科是指通过准确决策和精确应用恰当干预方法,实现病灶清除、器官保护和损伤控制的三要素平衡,达成高效、安全、微创的多目标优化和病人最大化健康获益的最佳临床实践。新时代的外科医生应广拓视野,以病人最大化健康获益为终极目标,促进外科技术、综合治疗、基础医学、生物医学工程学交叉融合的一系列临床实践,大力推动胆囊癌的精准治疗。Gallbladder cancer has the highest malignancy and worst prognosis as one of the most common malignant tumors of the digestive system.Currently,there are still many uncertainties within the field of gallbladder cancer,including how to determine the invasive metastatic range and micrometastases,boundaries of surgical resection,nonsurgical treatment options,and elective timing,all of which have to be optimized through the conceptualization and practice of precision surgery.Precision surgery refers to the achievement of balance between precise decision-making,precise application of appropriate intervention methods,and three key elements of lesion clearance,organ preservation,and injury control.This is all so that efficient,safe,minimally invasive,multi-objective optimization which maximizes the health benefits for patients can be achieved.Surgeons in the new era should broaden their horizons and carry out a series of clinical practices that promote the integration of surgical techniques,comprehensive treatment,basic medicine,and biomedical engineering with the ultimate goal of maximizing health benefits for patients,in order to zealously promoting the precision treatment of gallbladder cancer.

关 键 词：精准外科 胆囊癌 转化治疗 辅助治疗 综合治疗 免疫治疗 靶向治疗 化学治疗 

分 类 号：R6[医药卫生—外科学]