胰腺外科新方向——胰管修复外科

刘荣; 刘渠; 柳俨哲; 赵国栋

doi:10.3969/j.issn.2095-5227.2021.06.001

胰腺外科新方向——胰管修复外科

doi: 10.3969/j.issn.2095-5227.2021.06.001

解放军总医院肝胆胰外科医学部，北京　100853

详细信息

作者简介:
刘荣，男，博士，主任医师，解放军总医院肝胆胰外科医学部主任。研究方向：肝胆胰外科疾病治疗。Email: liurong301@126.com

通讯作者:
刘荣，主任医师，教授，博士生导师。现任解放军总医院肝胆胰外科医学部主任、全军肝胆外科研究所所长，总后勤部科技银星。在肝胆胰脾外科临床及科研一线工作30余年，致力于肝胆胰肿瘤腹腔镜/机器人微创手术治疗，以及人工智能与微创外科的交叉研究，创建了完整的肝胆胰脾外科腹腔镜技术体系和机器人技术体系。以第一完成人获国家科技进步二等奖、中华医学科技一等奖等奖励。任中国研究型医院学会智能医学专业委员会主任委员、中国研究型医院学会微创外科学专业委员会常务副主任委员兼秘书长、国际临床机器人外科学会执行委员、《中华腔镜外科杂志》(电子版)、Intelligent Surgery (《智能外科英文版》)杂志总编辑等职务。

中图分类号: R 735.9
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出版历程
- 收稿日期: 2021-06-07
- 网络出版日期: 2021-07-05
- 刊出日期: 2021-06-28

Pancreatic duct reconstructive surgery: A new direction for pancreas surgery

Faculty of Hepatopancreatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China

More Information

Corresponding author: LIU Rong. Email: liurong301@126.com

摘要

摘要: 目前对于与主胰管毗邻的良性肿瘤，常需要扩大范围切除，甚至实施胰腺-消化道吻合来完成肿瘤的切除，这种手术方式通常会医源性损失过多的正常胰腺组织，且破坏了正常的胰腺解剖生理，增加了术后并发症的发生风险。为了更好地恢复胰管的正常生理功能，笔者在总结胰管损伤或缺损后修复手术经验的基础上，提出了胰管修复外科的概念及应用范围，希望能够以最小的创伤实现最佳的预后。
- 胰腺外科 /
- 胰管损伤 /
- 修复外科 /
- 肿瘤切除
Abstract: For benign tumors adjacent to the main pancreatic duct, extensive resection or even pancreatic anastomosis is often required. However, these procedures usually result in the iatrogenic loss of excessive normal pancreatic tissue, and pancreatic anastomosis also destroys normal pancreatic anatomical structure, which increases the risk of postoperative complications. In order to better restore the normal physiological function of the pancreatic duct, the concept and application scope of pancreatic duct reconstructive surgery are suggested based on the summary of surgical experience in reconstructing the pancreatic duct after injury or defect, hoping to achieve the best prognosis for patients with minimal injury.
- pancreatic surgery /
- pancreatic duct injury /
- reconstructive surgery /
- tumor resection

HTML全文

图 1 胰管的解剖

Figure 1. Anatomy of the pancreatic duct

下载: 全尺寸图片幻灯片

图 2 胰腺肿瘤剜除联合主胰管架桥修复术

A：胰腺肿瘤剜除后胰管支架置入主胰管远近端；B：胰腺组织对拢缝合后

Figure 2. Pancreatic tumor enucleation combined with main pancreaticduct bridging repair

A: After enucleation of the pancreatic tumor, a stent wasinserted distally and proximally into the main pancreatic duct; B: Pancreatic tissue was sutured together

下载: 全尺寸图片幻灯片

图 3 胰腺中段切除、端-端吻合术^[9]

A：中段胰腺切除后；B：远近端主胰管内置入胰管支架；C：胰腺端-端对拢缝合；D：胰腺端-端吻合术后

Figure 3. An end-to-end pancreatic anastomosis in robotic centralpancreatectomy^[9]

A: Central pancreatectomy; B: A stent was inserted distally and proximally into the main pancreatic duct; C: End-to-end pancreatic anastomosis; D: Pancreatic tissue was suturedtogether With permission from [Wang ZZ，Zhao GD，Zhao ZM，et al], [Updates in Surgery]; published by [Springer Nature], [2021].

下载: 全尺寸图片幻灯片

图 4 分支胰管型IPMN局部切除

A：MRCP(箭头处为分支胰管型)；B：术中游离并结扎分支胰管

Figure 4. Partial resection of branch duct IPMN

A: MRCP (IPMN The arrow is branch duct IPMN); B: The branch pancreatic duct was dissected and ligated intra-operatively

下载: 全尺寸图片幻灯片

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