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中国腹腔镜胰十二指肠切除术20年胰肠重建术式变迁与未来发展

Laparoscopic pancreaticoduodenectomy over a 20-year period in China-Evolvement of reconstruction following pancreaticojejunostomy

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【作者】 白雪莉陈伟梁廷波

【Author】 Bai Xueli;Chen Wei;Liang Tingbo;Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine, Innovation Center for the Study of Pancreatic Diseases Zhejiang Province, Clinical Medical Research Center for Hepatobiliary Pancreatic Diseases,Zhejiang Province, Zhejiang Provincial Key Laboratory of Pancreatic Disease;

【通讯作者】 梁廷波;

【机构】 浙江大学医学院附属第一医院肝胆胰外科浙江省胰腺病研究重点实验室浙江省重症胰腺疾病诊治技术研究中心浙江省肝胆胰疾病临床医学研究中心

【摘要】 近20年来,腹腔镜胰十二指肠切除术在中国发展迅速,在很多中心已经成为一种常规手术。胰肠吻合重建是决定腹腔镜胰十二指肠切除术成败的关键步骤。随着微创外科技术的发展,种类众多的胰肠吻合方式也应运而生。每种胰肠吻合方式均有其优缺点和适用人群,胰管对空肠黏膜吻合及其改良方式成为主流选择,但尚无任何一种方式能完全避免胰瘘的发生。在临床实践中,综合考虑患者的实际情况、术者熟练程度以及术中具体情况,选择个体化的胰肠吻合方式并提高吻合质量,才是减少术后胰瘘发生的关键。

【Abstract】 In the past 20 years, laparoscopic pancreaticoduodenectomy(LPD) has developed rapidly in China and has become a routine operation in many centers. Pancreaticojejunostomy is a key step in LPD. A wide variety of pancreaticojejunostomy have emerged with the development of minimally invasive surgery. Each type of pancreaticojejunal anastomosis has its advantages and disadvantages as well as its suitable population. Duct to mucosal anastomosis and its improved methods have become the mainstream choices, but none of them can completely avoid the occurrence of pancreatic fistula. In clinical practice, the key to reduce the occurrence of postoperative pancreatic fistula is to select individualized pancreaticojejunostomy and improve the anastomosis quality by comprehensively considering the actual situation of the patient,the proficiency of the operator and the specific situation during the operation.

【基金】 国家自然科学基金面上项目(81871925,81672337);浙江省重点研发项目(2020C03117)~~
  • 【文献出处】 中华普外科手术学杂志(电子版) ,Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) , 编辑部邮箱 ,2021年03期
  • 【分类号】R657.5;R656.64
  • 【被引频次】2
  • 【下载频次】201
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