临床外科杂志 ›› 2024, Vol. 32 ›› Issue (7): 776-779.doi: 10.3969/j.issn.1005-6483.2024.07.029

• 综述与讲座 • 上一篇    下一篇

基于SELECT理念腹腔镜下保留脾脏的胰体尾切除

李爽 张标 刘航宇 祁冰 Thomas Juby 张桂信 张庆凯 尚东   

  1. 116011 大连医科大学附属第一医院普外三科
  • 收稿日期:2024-07-18 出版日期:2024-07-20 发布日期:2024-07-20
  • 通讯作者: 尚东,Email:shangdong@dmu.edu.cn;张庆凯, Email:dlkaiyu@163.com
  • 基金资助:
    国家自然科学基金(81873156,82000075);大连“登峰计划”科研项目 (DF2023034);大连医科大学胆胰疾病中西医结合防治交叉科研合作课题组资助(JCHZ 2023005)

Laparoscopic spleen-preserving distal pancreatectomy based on the SELECT concept

LI Shuang,ZHANG Biao,LIU Hangyu,QI Bing,Thomas Juby,ZHANG Guixin,ZHANG Qingkai,SHANG Dong   

  1. Department of General Surgery Ⅲ,the First Affiliated Hospital of Dalian Medical University,Liaoning 116011,China
  • Received:2024-07-18 Online:2024-07-20 Published:2024-07-20

摘要: 腹腔镜下胰体尾切除术目前已经成为治疗胰腺体尾部肿瘤的标准术式。而腹腔镜下保留脾脏的胰体尾切除术由于可保留脾脏功能,减少脾切除术后并发症,越来越受到重视。然而,胰腺肿瘤发病隐匿、解剖位置复杂,这些对其诊断和保留脾脏的胰体尾切除术带来了挑战。近年来,我们团队积累了丰富的胰腺肿瘤诊疗经验,创新提出“SELECT” ( S- Single-Operator Cholangiopancreatoscopy,E-ERCP,L-Laparoscopy,E-Endoscopic ultrasound,C-Choledochoscopy/Confocal laser endomicroscopy,T-Traditional Chinese medicine)多镜组合中西医微创诊治理念。根据胰腺肿瘤的类型及特点,应用多种内镜和腹腔镜技术,多种不同微创诊疗方法的优选组合,围手术期采用中医药,进行中西医结合加速康复。将SELECT理念充分应用于腹腔镜下保留脾脏的胰体尾切除术,有利于术前精准诊断、术中精准切除、术后并发症预判和治疗,一站式诊治胰腺肿瘤,使病人利益最大化。

关键词: SELECT理念, 多镜联合, 胰腺肿瘤, 保留脾脏, 胰体尾切除术

Abstract: Laparoscopic distal pancreatectomy is the conventional treatment for tumors of the pancreatic body or tail.And laparoscopic spleen-preserving distal pancreatectomy has been emphasized because it can preserve the spleen’s function and lower the complications following splenectomy.However,the occult onset and complex anatomical location of pancreatic tumors pose a challenge to their diagnosis and spleen-preserving distal pancreatectomy.In recent years,our team has accumulated rich experience in the diagnosis and treatment of pancreatic tumors,and innovatively proposed the “SELECT” concept (S-Single-Operator Cholangiopancreatoscopy,E-ERCP,L-Laparoscopy,E-Endoscopic ultrasound,C-Choledochoscopy/Confocal laser endomicroscopy,T-Traditional Chinese medicine) for diagnosis and treatment.Based on the various characteristics of pancreatic tumors,various endoscopic and laparoscopic techniques are applied,and an optimal combination of various minimally invasive methods is selected.Fully applying the SELECT concept to laparoscopic spleen-preserving distal pancreatectomy is conducive to accurate preoperative diagnosis,accurate intraoperative resection,prediction and treatment of postoperative complications,and one-stop diagnosis and treatment of pancreatic tumors,maximizing patient benefits.

Key words: SELECT concept, Combined multiple endoscopic and laparoscopic surgery, pancreatic tumor, spleen preservation, distal pancreatectomy

[1] 陈曦 袁寅 李迎春 王宏刚 李立军 杨兴业 刘庆宏. 动脉优先入路联合根治性顺行模块化胰脾切除术在胰体尾癌联合多脏器切除术中的应用[J]. 临床外科杂志, 2023, 31(7): 644-648.
[2] 黄鹤光, 林贤超. 机器人手术在胰腺肿瘤治疗中的现状及展望[J]. 临床外科杂志, 2019, 27(12): 1018-1020.
[3] 余昌中, 田驹, 杨荣华, 于聪慧, 巨邦律, 柰超, 梅建民. 腹腔镜胰体尾切除术在胰尾癌手术治疗中的应用及对生活质量评分的影响研究[J]. 临床外科杂志, 2019, 27(12): 1077-1079.
[4] 宁登, 姜立, 陈孝平. 胰体尾切除术后的胰漏防治[J]. 临床外科杂志, 2019, 27(12): 1088-1090.
[5] 谈震, 周斌, 陈鹏等. 胰腺良性与交界性肿瘤:胰腺中段切除术与胰体尾切除术的临床疗效对比分析[J]. 临床外科杂志, 2018, 26(12): 936-939.
[6] 玛依努尔艾力 阿布力克木毛拉尤甫 郑超 张华. 不可切除的胰腺癌预后相关因素分析[J]. 临床外科杂志, 2012, 20(1): 39-39.
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