文章摘要

创新性桥梁合拢理论对改变胰腺良性病外科手术方法的推动

作者: 1刘 荣, 1赵 国栋
1 中国人民解放军总医院 肝胆外二科,北京 100853
通讯: 刘 荣 Email: Liurong301@126.com
DOI: 10.3978/.
基金: 国家自然科学基金资助项目(81500499);国家重点研发计划资助项目(2017YFC0110405)。

摘要

胰腺良性肿瘤较为常见,多数需手术治疗,剜除或局部切除是最为理想的手术方式,但当病变体积稍大、与主胰管距离过近或术中损伤主胰管时,众多临床指南推荐节段性切除、胰肠吻合或胰十二指肠切除术,前述方法对于胰腺良性疾病而言,目的性创伤较大,胰腺切除较多,正常生理解剖被迫改变。笔者应用创新性桥梁合拢理论进行胰腺良性疾病新术式的临床探索性研究,手术方式主要以主胰管架桥修复和选择胰腺端端对吻重建术为基础,对良性疾病切除后缺损的胰腺进行整形修复术,还原正常解剖。初步临床结果较好地证实了该理论和技术方法的可行性和安全性,有望纠正主胰管无法重建的传统错误认知,彻底改变胰腺良性疾病的外科治疗的方法。
关键词: 胰腺肿瘤;胰腺切除术;胰腺管;修复外科手术;机器人手术

Promotion of innovative theory of bridge closure in changing traditional surgical approaches for benign pancreatic diseases

Authors: 1LIU Rong, 1ZHAO Guodong
1 Department II of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China

CorrespondingAuthor:LIU Rong Email: Liurong301@126.com

Abstract

Benign tumors of the pancreas are not rare, and most of them require surgical treatment, for which the enucleation or local resection is the best procedure. However, for lesions with relative large size or very close to the main pancreatic duct, or when there is intraoperative injury of the main pancreatic duct, then segmental resection, pancreaticojejunostomy or pancreaticoduodenectomy are recommended by most clinical guidelines. The above-mentioned procedures for benign conditions of the pancreas will result in greater intentional surgical trauma, excessive pancreatic resection, and unavoidable anatomical and physiological changes. The authors performed an investigative clinical research in a new procedure for benign pancreatic diseases using an innovative theory of bridge closure. The procedure, mainly based on main pancreatic duct bridging repair and end-to-end pancreatic anastomosis reconstruction, plastically repairs the defect of the pancreas after excision of the benign lesion and then restores the normal anatomy. Preliminary clinical results have verified the feasibility and safety of this theory and technique, which is hopeful to correct the traditional misunderstanding that the main pancreatic duct is unreconstructable, and completely change the surgical treatment modalities for benign pancreatic diseases.
Keywords: Pancreatic Neoplasms; Pancreatectomy; Pancreatic Ducts; Reconstructive Surgical Procedures; Robotic Surgical Procedures