Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Front Med. 2011 Sep;5(3):277-82. doi: 10.1007/s11684-011-0147-5. Epub 2011 Oct 2.
Laparoscopic pancreatic surgery has been gaining increasing recognition in recent years, and its practice has increased despite its highly complex procedure and longer learning curve compared with surgeries for other abdominal organs. Laparoscopic distal pancreatectomy and tumor enucleation are two of the fastest-growing techniques and are currently in wide use because of their comparable technical simplicity. Literature review showed that laparoscopic distal pancreatectomy and enucleation are safe and efficient approaches for benign and low-degree malignant tumors; however, the indication for malignant tumors remains controversial. Laparoscopic pancreaticoduodenectomy is practiced in a limited number of surgical centers and presented as case reports or in small series. Although its feasibility was demonstrated by many surgeons, whether the laparoscopic procedure can achieve benefits comparable to or even more prominent than those of an open procedure has not been clinically proven. Prospective, randomized, controlled trials of laparoscopic operation versus open pancreatic surgery are necessary to justify the wide application and routine practice of the laparoscopic procedure for pancreatic lesions.
近年来，腹腔镜胰腺手术得到了越来越多的认可，尽管与其他腹部器官的手术相比，其操作过程更为复杂，学习曲线更长，但它的应用却在不断增加。腹腔镜胰体尾切除术和肿瘤剜除术是发展最快的两种技术，由于其技术相对简单，目前应用广泛。文献回顾显示，腹腔镜胰体尾切除术和肿瘤剜除术对于良性和低度恶性肿瘤是安全有效的方法；然而，对于恶性肿瘤的适应证仍存在争议。腹腔镜胰十二指肠切除术仅在少数外科中心开展，且多以病例报告或小系列形式呈现。虽然许多外科医生已经证明了其可行性，但腹腔镜手术是否能达到与开放手术相当甚至更突出的效果，尚未得到临床证实。有必要进行腹腔镜手术与开放胰腺手术的前瞻性、随机、对照临床试验，以证明腹腔镜手术治疗胰腺病变的广泛应用和常规实践是合理的。
