徐建威;展翰翔;王磊;
XU Jian-wei;ZHAN Han-xiang;WANG Lei;Department of General Surgery,Qilu Hospital,Shandong University;

• 1:山东大学齐鲁医院胰腺外科

摘要(Abstract)：

胰腺中段切除术(central pancreatectomy,CP)是一类保留胰腺及脏器功能的手术。随着胰腺外科微创技术的发展,腹腔镜胰腺中段切除术(laparoscopic central pancreatectomy,LCP)在大的胰腺中心已经成为常规术式。由于CP手术适应证具有局限性,手术操作复杂且存在较高的术后并发症发生率,很少有超过100例CP的单中心报道。本文主要介绍CP的发展历史、适应证/禁忌证、短期/长期并发症以及LCP手术技巧。
As an organ-preservation procedure,laparoscopic central pancreatectomy has been performed routinely in large pancreatic centers. Due to the limitation of indications,the complexion of the operation,and higher incidence of complications, there are few publications with more than 100 cases of central pancreatectomy reported by a single center. The current article reviews the history,indications and contraindications,short-and long-term complications,and laparoscopic techniques of central pancreatectomy.

关键词(KeyWords)： 微创外科;胰腺中段切除术;功能保留;胰腺外科
minimally invasive surgery;central pancreatectomy;organ-preservation procedure;pancreatic resection

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金青年项目(81502051);; 山东省自然科学基金青年项目(ZR2015HQ010)

作者(Authors): 徐建威;展翰翔;王磊;
XU Jian-wei;ZHAN Han-xiang;WANG Lei;Department of General Surgery,Qilu Hospital,Shandong University;

参考文献(References)：

• [1]Iacono C,Ruzzenente A,Bortolasi L,et al.Central pancreatectomy:the Dagradi Serio Iacono operation.Evolution of a surgical technique from the pioneers to the robotic approach[J].World J Gastroenterol,2014,20:15674-15681.
• [2]Finney JM.Resection of the Pancreas:Report of a Case[J].Ann Surg,1910,51:818-829.
• [3]Guillemin P,Bessot M.[Chronic calcifying pancreatitis in renal tuberculosis:pancreatojejunostomy using an original technic][J].Mem Acad Chir(Paris),1957,83:869-871.
• [4]Letton AH,Wilson JP.Traumatic severance of pancreas treated by Roux-Y anastomosis[J].Surg Gynecol Obstet,1959,109:473-478.
• [5]Baca I,Bokan I.Laparoscopic segmental pancreas resection and pancreatic cystadenoma[J].Chirurg,2003,74:961-965.
• [6]Giulianotti PC,Sbrana F,Bianco FM,et al.Robot-assisted laparoscopic pancreatic surgery:single-surgeon experience[J].Surg Endosc,2010,24:1646-1657.
• [7]Kang CM,Lee JH,Lee WJ.Minimally invasive central pancreatectomy:current status and future directions[J].JHepatobiliary Pancreat Sci,2014,21:831-840.
• [8]Zhang RC,Zhang B,Mou YP,et al.Comparison of clinical outcomes and quality of life between laparoscopic and open central pancreatectomy with pancreaticojejunostomy[J].Surg Endosc,2017,31:4756-4763.
• [9]刘渠,刘荣.机器人胰腺外科的应用与发展[J].外科理论与实践,2017,22:96-98.
• [10]彭承宏,施昱晟,吴志翀.机器人胰腺肿瘤手术难点与对策[J].中国实用外科杂志,2016,36:1158-1161.
• [11]Santangelo M,Esposito A,Tammaro V,et al.What indication,morbidity and mortality for central pancreatectomy in oncological surgery?A systematic review[J].Int J Surg,2016,28:S172-S176.
• [12]Bassi C.Middle segment pancreatectomy:a useful tool in the management of pancreatic neoplasms[J].J Gastrointest Surg,2007,11:421-424.
• [13]Dumitrascu T,Scarlat A,Ionescu M,et al.Central pancreatectomy:an oncologically safe option to treat metastases of other neoplasms of the mid-portion of the pancreas?[J].Ann Hepatobiliary Pancreat Surg,2017,21:76-79.
• [14]Iacono C,Bortolasi L,Facci E,et al.The Dagradi-SerioIacono operation central pancreatectomy[J].J Gastrointest Surg,2007,11:364-376.
• [15]蒋奎荣,苗毅,徐泽宽,等.中段胰腺切除术在胰腺良性或低度恶性肿瘤中的应用[J].肝胆外科杂志,2008,16:92-94.
• [16]Sauvanet A,Partensky C,Sastre B,et al.Medial pancreatectomy:a multi-institutional retrospective study of 53patients by the French Pancreas Club[J].Surgery,2002,132:836-843.
• [17]Di Norcia J,Ahmed L,Lee MK,et al.Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland lesions[J].Surgery,2010,148:1247-1254;discussion:1254-1256.
• [18]Goudard Y,Gaujoux S,Dokmak S,et al.Reappraisal of central pancreatectomy a 12-year single-center experience[J].JAMA Surg,2014,149:356-363.
• [19]Bassi C,Marchegiani G,Dervenis C,et al.The 2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 Years After[J].Surgery,2017,161:584-591.
• [20]Pulvirenti A,Marchegiani G,Pea A,et al.Clinical Implications of the 2016 International Study Group on Pancreatic Surgery Definition and Grading of Postoperative Pancreatic Fistula on 775 Consecutive Pancreatic Resections[J].Ann Surg,2017,268:1069-1075.
• [21]Iacono C,Verlato G,Ruzzenente A,et al.Systematic review of central pancreatectomy and meta-analysis of central versus distal pancreatectomy[J].Br J Surg,2013,100:873-885.
• [22]Crippa S,Bassi C,Warshaw AL,et al.Middle pancreatectomy:indications,short-and long-term operative outcomes[J].Ann Surg,2007,246:69-76.
• [23]Kollar D,Huszar T,Poharnok Z,et al.A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy[J].Dig Surg,2016,33:320-328.
• [24]Ecker BL,McMillan MT,Allegrini V,et al.Risk Factors and Mitigation Strategies for Pancreatic Fistula After Distal Pancreatectomy:Analysis of 2026 Resections From the International,Multi-institutional Distal Pancreatectomy Study Group[J].Ann Surg,2017,269:143-149.
• [25]Wayne M,Neragi-Miandoab S,Kasmin SF,et al.Central pancreatectomy without anastomosis[J].World J Surg Oncol,2009,7:67.
• [26]Qin H,Luo L,Zhu Z,et al.Pancreaticogastrostomy has advantages over pancreaticojejunostomy on pancreatic fistula after pancreaticoduodenectomy.A meta-analysis of randomized controlled trials[J].Int J Surg,2016,36:18-24.
• [27]Tittelbach-Helmrich D,Keck T,Wellner UF.[Pancreaticogastrostomy:when and how?][J].Chirurg,2017,88:11-17.
• [28]刘续宝,熊俊杰.从远期生活质量再议胰肠吻合与胰胃吻合合理选择[J].中国实用外科学杂志,2016,36:839-842.
• [29]张太平,徐建威,赵玉沛.胰腺中段切除术的要点与技巧[J].国际外科学杂志,2011,38:860-862.
• [30]Hosotani R,Doi R,Imamura M.Duct-to-mucosa pancreaticojejunostomy reduces the risk of pancreatic leakage after pancreatoduodenectomy[J].World J Surg,2002,26:99-104.
• [31]Payne RF,Pain JA.Duct-to-mucosa pancreaticogastrostomy is a safe anastomosis following pancreaticoduodenectomy[J].Br J Surg,2006,93:73-77.
• [32]Bassi C,Falconi M,Molinari E,et al.Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy:results of a prospective randomized trial[J].Surgery,2003,134:766-771.
• [33]El Nakeeb A,El Hemaly M,Askr W,et al.Comparative study between duct to mucosa and invagination pancreaticojejunostomy after pancreaticoduodenectomy:a prospective randomized study[J].Int J Surg,2015,16:1-6.
• [34]Zhang S,Lan Z,Zhang J,et al.Duct-to-mucosa versus invagination pancreaticojejunostomy after pancreaticoduodenectomy:a meta-analysis[J].Oncotarget,2017,8:46449-46460.