机器人肝门部胆管癌根治术围手术期并发症的预防  

Preventive strategies for perioperative complications of robotic radical surgery for hilar cholangiocarcinoma

作　　者：陈卫波 赵国栋 Chen Weibo;Zhao Guodong(Department of Hepatopancreatobiliary Surgery,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China;Faculty of Hepatopancreatobiliary Surgery,the First Medical Center of Chinese People's Liberation Army(PLA)General Hospital,Beijing 100853,China)

机构地区：[1]苏州大学附属第三医院肝胆胰外科,常州213003 [2]中国人民解放军总医院第一医学中心肝胆胰外科医学部,北京100853

出　　处：《中华肝胆外科杂志》2024年第9期699-702,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：常州市卫健委重大科技项目(ZD202305);江苏省"333"高层次人才培养工程项目(2022,3-4-086);常州市"十四五"卫生健康高层次人才培养工程项目(2022260-67);常州市科技局社会发展科技支撑项目(CE20225043)。

摘　　要：肝门部胆管癌手术复杂繁琐,操作涉及肝切除、淋巴结清扫、胆管成型和高位胆肠吻合,并发症发生率高。机器人辅助肝门部胆管癌根治术已在临床应用。对比传统开放手术,机器人辅助肝门部胆管癌根治术术后并发症的种类和发生率有所不同。本文以开展的手术为基础,结合文献回顾,分析机器人辅助肝门部胆管癌根治术并发症,就术前准备相关并发症、肝切除相关并发症、淋巴结清扫和血管处理相关并发症、高位胆肠吻合相关并发症、肿瘤根治相关并发症和远期胆道相关并发症等六方面进行阐述,以期为开展机器人肝门部胆管癌根治术的医师提供些许借鉴。Surgery for hilar cholangiocarcinoma remains technically demanding,which involves liver resection,lymph node dissection,bile duct plasty,and high-site biliojejunostomy,often with a high complication rate.Robotic radical resection of hilar cholangiocarcinoma has been practiced in selected patients in some experienced hands.Compared with traditional open surgery,the types and incidence of postoperative complications of robot surgery for hilar cholangiocarcinoma are different.Based on the current case series and a literature review,we analyzed the complications of robot-assisted surgery for hilar cholangiocarcinoma,and discusses the prevention strategy of six types of complications,including complications related to:preoperative evaluation and preparement,liver resection,lymph node dissection and vascular procedure,high-site bile-jejunum anastomosis,tumor radical resection,and long-term biliary-related complications.We aim to provide some technical reference for surgeons in the future practice of robot-assisted radical resection for hilar cholangiocarcinoma.

关 键 词：Klatskin肿瘤 机器人手术 并发症 预防 

分 类 号：R735.8[医药卫生—肿瘤]