基于SELECT理念腹腔镜下保留脾脏的胰体尾切除  

Laparoscopic spleen-preserving distal pancreatectomy based on the SELECT concept

作　　者：李爽[1] 张标 刘航宇 祁冰[1] Thomas Juby 张桂信[1] 张庆凯[1] 尚东[1] LI Shuang;ZHANG Biao;LIU Hangyu;QI Bing;Thomas Juby;ZHANG Guixin;ZHANG Qingkai;SHANG Dong(Department of General SurgeryⅢ,the First Affiliated Hospital of Dalian Medical University,Liaoning 116011,China)

机构地区：[1]大连医科大学附属第一医院普外三科,116011

出　　处：《临床外科杂志》2024年第7期776-779,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金(81873156,82000075);大连“登峰计划”科研项目(DF2023034);大连医科大学胆胰疾病中西医结合防治交叉科研合作课题组资助(JCHZ 2023005)。

摘　　要：腹腔镜下胰体尾切除术目前已经成为治疗胰腺体尾部肿瘤的标准术式。而腹腔镜下保留脾脏的胰体尾切除术由于可保留脾脏功能,减少脾切除术后并发症,越来越受到重视。然而,胰腺肿瘤发病隐匿、解剖位置复杂,这些对其诊断和保留脾脏的胰体尾切除术带来了挑战。近年来,我们团队积累了丰富的胰腺肿瘤诊疗经验,创新提出“SELECT”(S-Single-Operator Cholangiopancreatoscopy,E-ERCP,L-Laparoscopy,E-Endoscopic ultrasound,C-Choledochoscopy/Confocal laser endomicroscopy,T-Traditional Chinese medicine)多镜组合中西医微创诊治理念。根据胰腺肿瘤的类型及特点,应用多种内镜和腹腔镜技术,多种不同微创诊疗方法的优选组合,围手术期采用中医药,进行中西医结合加速康复。将SELECT理念充分应用于腹腔镜下保留脾脏的胰体尾切除术,有利于术前精准诊断、术中精准切除、术后并发症预判和治疗,一站式诊治胰腺肿瘤,使病人利益最大化。Laparoscopic distal pancreatectomy is the conventional treatment for tumors of the pancreatic body or tail.And laparoscopic spleen-preserving distal pancreatectomy has been emphasized because it can preserve the spleen’s function and lower the complications following splenectomy.However,the occult onset and complex anatomical location of pancreatic tumors pose a challenge to their diagnosis and spleen-preserving distal pancreatectomy.In recent years,our team has accumulated rich experience in the diagnosis and treatment of pancreatic tumors,and innovatively proposed the“SELECT”concept(S-Single-Operator Cholangiopancreatoscopy,E-ERCP,L-Laparoscopy,E-Endoscopic ultrasound,C-Choledochoscopy/Confocal laser endomicroscopy,T-Traditional Chinese medicine)for diagnosis and treatment.Based on the various characteristics of pancreatic tumors,various endoscopic and laparoscopic techniques are applied,and an optimal combination of various minimally invasive methods is selected.Fully applying the SELECT concept to laparoscopic spleen-preserving distal pancreatectomy is conducive to accurate preoperative diagnosis,accurate intraoperative resection,prediction and treatment of postoperative complications,and one-stop diagnosis and treatment of pancreatic tumors,maximizing patient benefits.

关 键 词：SELECT理念 多镜联合 胰腺肿瘤 保留脾脏 胰体尾切除术 

分 类 号：R735.9[医药卫生—肿瘤]