Chu Carrie K, Kooby David A
Department of Surgery, Emory University School of Medicine, 1364 Clifton Road, NE, H120, Atlanta, GA 30322, USA.
Surg Oncol Clin N Am. 2010 Apr;19(2):311-33. doi: 10.1016/j.soc.2009.11.008.
The rapid growth of minimally invasive technology and experience in recent decades has revolutionized many aspects of oncologic surgery. Adoption of laparoscopic pancreatectomy has been slow due to the inherent anatomic complexity of pancreatic surgery, as well as concerns of perioperative complications and compromised oncologic results. With increasing surgeon experience and growing data, laparoscopic pancreatic resection is generating considerable attention and enthusiasm. This article provides an overview of laparoscopic pancreatic tumor surgery with respect to tumor biology and technical approaches. Current applications of laparoscopic approaches to left pancreatectomy, tumor enucleation, central pancreatectomy, and pancreaticoduodenectomy for treatment of pancreatic tumors are considered in light of available evidence demonstrating feasibility, safety, and oncologic efficacy. Future directions in minimally invasive pancreatic surgery are explored.
近几十年来,微创技术的迅速发展和经验积累已经彻底改变了肿瘤外科的许多方面。由于胰腺手术固有的解剖复杂性,以及对围手术期并发症和肿瘤治疗效果受损的担忧,腹腔镜胰腺切除术的采用一直较为缓慢。随着外科医生经验的增加和数据的不断积累,腹腔镜胰腺切除术正引起广泛关注并激发人们的热情。本文就肿瘤生物学和技术方法对腹腔镜胰腺肿瘤手术进行概述。根据现有证据证明的可行性、安全性和肿瘤治疗效果,考虑腹腔镜手术方法在治疗胰腺肿瘤的左胰腺切除术、肿瘤剜除术、中段胰腺切除术和胰十二指肠切除术中的当前应用。同时探讨微创胰腺手术的未来发展方向。