Department of General and Pancreatic Surgery, Verona University Hospital, Verona, Italy.
Department of Surgery, Amsterdam UMC, location VU, Amsterdam, The Netherlands.
BJS Open. 2023 Sep 5;7(5). doi: 10.1093/bjsopen/zrad081.
Pancreatic surgery is increasingly moving towards centralization in high-volume centres, supported by evidence on the volume-outcome relationship. At the same time, minimally invasive pancreatic surgery is becoming more and more established worldwide, and interest in new techniques, such as robotic pancreatoduodenectomy, is growing. Such recent innovations are reshaping modern pancreatic surgery, but they also represent new challenges for surgical training in its current form.
This narrative review presents a chosen selection of literature, giving a picture of the current state of training in pancreatic surgery, together with the authors' own views, and in the context of centralization and innovation towards minimally invasive techniques.
Centralization of pancreatic surgery at high-volume centres, volume-outcome relationships, innovation through minimally invasive technologies, learning curves in both traditional and minimally invasive surgery, and standardized training paths are the different, but deeply interconnected, topics of this article. Proper training is essential to ensure quality of care, but innovation and centralization may represent challenges to overcome with new training models.
Innovations in pancreatic surgery are introduced with the aim of increasing the quality of care. However, their successful implementation is deeply dependent on dissemination and standardization of surgical training, adapted to fit in the changing landscape of modern pancreatic surgery.
胰腺手术正逐渐向高容量中心集中，这一趋势得到了手术量与预后关系的证据支持。与此同时，微创胰腺手术在全球范围内越来越成熟，人们对机器人胰十二指肠切除术等新技术的兴趣也日益浓厚。这些新的创新正在重塑现代胰腺手术，但也对当前形式的外科培训带来了新的挑战。
本综述选择了一些文献，介绍了胰腺外科培训的现状，同时结合了作者自己的观点，并结合了集中化和向微创技术创新的背景。
胰腺手术在高容量中心的集中化、手术量与预后的关系、微创技术的创新、传统和微创手术的学习曲线以及标准化的培训路径是本文的不同但密切相关的主题。适当的培训对于确保医疗质量至关重要，但创新和集中化可能代表着需要通过新的培训模式来克服的挑战。
本文介绍了胰腺外科的创新，旨在提高医疗质量。然而，这些创新的成功实施在很大程度上取决于外科培训的传播和标准化，以适应现代胰腺外科不断变化的格局。
