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慢性胰腺炎的外科治疗:过去、现在与未来

Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future.

作者信息

Plagemann Stephanie, Welte Maria, Izbicki Jakob R, Bachmann Kai

机构信息

Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.

出版信息

Gastroenterol Res Pract. 2017;2017:8418372. doi: 10.1155/2017/8418372. Epub 2017 Jul 27.

Abstract

The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment. Although surgical procedures have become safer and more efficient than ever, the overall perioperative morbidity after pancreatic surgery remains high and management of postoperative complications stagnates. Current research focuses on the prevention of complications, optimizing the patient's general condition preoperatively and finding the appropriate timing for surgical treatment.

摘要

胰腺是人体中最后一批被探索的器官之一。最初的外科手术尝试是在尚未完全了解该腺体功能的情况下进行的。在发现胰岛素、血型以及最终实现献血可能性之前,外科手术的成功率一直较低。几个世纪以来,与适当的切除联合引流手术相比,手术方式从根治性切除发展到最小限度切除或仅对腺体进行引流。如今,由于手术医生经验丰富、胰腺手术集中在专科中心进行以及围手术期治疗得到优化,这些广为人知且标准化的手术被认为是安全的。尽管手术操作比以往任何时候都更安全、更高效,但胰腺手术后的总体围手术期发病率仍然很高,术后并发症的管理也停滞不前。当前的研究重点是预防并发症、术前优化患者的一般状况以及找到合适的手术治疗时机。

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