Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Asian J Surg. 2018 Mar;41(2):106-114. doi: 10.1016/j.asjsur.2016.09.003. Epub 2016 Sep 27.
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures. In contrast, LCP and LTP have not been widely accepted as common laparoscopic procedures owing to their complicated reconstruction and limited indications. Nevertheless, our concise review reveals that LCP and LTP performed by expert laparoscopic surgeons can result in good short-term and long-term outcomes. Moreover, as surgeons' experience with laparoscopic techniques continues to grow around the world, new innovations and breakthroughs in MIPS will evolve. Well-designed and suitably powered randomized controlled trials of LPD, LDP, LCP, and LTP are now warranted to demonstrate the superiority of these procedures.
本文综述了微创胰腺手术（MIPS）的最新进展和现状。典型的 MIPS 手术包括腹腔镜胰十二指肠切除术（LPD）、腹腔镜胰体尾切除术（LDP）、腹腔镜胰腺中段切除术（LCP）和腹腔镜全胰切除术（LTP）。一些回顾性研究比较了 LPD 或 LDP 与开放性手术，证明了这些手术的安全性和可行性，以及术中结果和术后恢复情况。相比之下，由于其复杂的重建和有限的适应证，LCP 和 LTP 尚未被广泛接受为常见的腹腔镜手术。然而，我们的简要综述表明，由经验丰富的腹腔镜外科医生进行的 LCP 和 LTP 可以带来良好的短期和长期结果。此外，随着全球外科医生对腹腔镜技术经验的不断增加，MIPS 将出现新的创新和突破。现在有必要进行设计良好且具有足够效力的 LPD、LDP、LCP 和 LTP 的随机对照试验，以证明这些手术的优越性。
