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腹腔镜胰十二指肠切除术胰腺颈部离断的方法选择

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中华外科杂志 2017年第9期55卷 667-670页

作者：林荣贵黄鹤光陈燕昌陆逢春林贤超杨媛媛方海宗王丛菲福建医科大学附属协和医院基本外科福州350001

目的探讨腹腔镜胰十二指肠切除术中胰腺颈部离断的方法、处理技巧和经验。方法回顾性分析2014年12月至2017年1月福建医科大学附属协和医院基本外科对58例壶腹周围肿瘤患者行腹腔镜胰十二指肠切除术的病例资料。男性26例，女性32例，年... 详细信息

目的探讨腹腔镜胰十二指肠切除术中胰腺颈部离断的方法、处理技巧和经验。方法回顾性分析2014年12月至2017年1月福建医科大学附属协和医院基本外科对58例壶腹周围肿瘤患者行腹腔镜胰十二指肠切除术的病例资料。男性26例，女性32例，年龄18—65岁，平均年龄（46-12）岁。结果58例患者均手术顺利，3例因早期学习曲线于腹腔镜下完整切除标本后取辅助切口行开放吻合，2例因肿瘤侵犯门静脉或肠系膜上静脉中转开放手术，余53例完全腹腔镜或腹腔镜联合机器人完成手术。42例先结扎胃十二指肠动脉，贯通胰后隧道悬吊胰腺后再由下往上离断胰腺颈部；13例充分分离胰后间隙，由下往上离断胰腺颈部，结扎胃十二指肠动脉；3例先结扎胃十二指肠动脉．游离胰腺颈部上缘的门静脉和胰腺颈部下缘的肠系膜上静脉，由前往后逐步离断胰腺颈部。平均断胰时间（34．9-9．7）min，平均断胰出血量（30．1±8．2）ml。术后并发症主要包括，胰瘘7例（生化漏2例。B级3例，C级2例），胆瘘3例，胃瘘1例，胃排空延迟（C级）1例，腹腔感染5例，肝功能衰竭1例。腹腔出血2例，再次手术2例，1例围手术期死亡，其余患者均康复出院。术后平均住院时间（14．2-5．1）d。结论胰腺颈部的离断是腹腔镜胰十二指肠切除术的重要步骤，应充分重视，同时应根据术中探查情况结合术前影像学检查选择合适的离断胰腺颈部的方法。

关键词：腹腔镜检查胰十二指肠切除术壶腹周围肿瘤

The current surgical treatment of pancreatic neuroendocrine neoplasms in China: a national wide cross-sectional study

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Journal of Pancreatology 2019年第2期2卷 35-42页

作者： Wenming Wu Gang Jin Haimin Li Yi Miao Chunyou Wang Tingbo Liang Jinrui Ou Yongfu Zhao Chunhui Yuan Yixiong Li Wenhui Lou Zheng Wu Renyi Qin Huaizhi Wang Jihui Hao Xianjun Yu heguang huang Guang Tan Xubao Liu Kesen Xu Lei Wang Yinmo Yang Chunyi Hao Weilin Wang Kejian Guo Junmin Wei Yifan Wang Chenghong Peng Xuefeng Wang Shouwang Cai Jianxin Jiang Xinmin Wu Xiao Yu Fei Li Yupei Zhao 无 Department of General Surgery Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Pancreatic Surgery Shanghai Chang Hai Hospital Affiliated to The Second Military Medical UniversityShanghaiChina Department of Hepato-Biliary-Pancreatic Surgery Xijing Hospital Affiliated to the Fourth Military Medical UniversityXi’anChina Department of General Surgery Jiangsu Province HospitalThe First Affiliated Hospital to Nanjing Medical UniversityNanjingChina Department of General Surgery Union Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Hepato-Biliary-Pancreatic Surgery The Second Affiliated HospitalZhejiang UniversityHangzhouChina Department of General Surgery Guangdong General HospitalGuangzhouChina Department of Hepato-Biliary-Pancreatic Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Department of General Surgery Peking University Third HospitalBeijingChina Department of Pancreatic Surgery Xiangya Hospital Affiliated to Central South UniversityChangshaChina Department of Pancreatic Surgery Shanghai Zhongshan Hospital Affiliated to Fu Dan UniversityShanghaiChina Department of General Surgery The First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anChina Department of Pancreatic Surgery Tongji Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science&TechnologyWuhanChina Institute of Hepatopancreatobiliary Surgery Chongqing General HospitalUniversity of Chinese Academy of SciencesChongqingChina Department of Pancreatic Surgery Tianjin Medical University Cancer Institute&HospitalTianjinChina Department of Pancreatic Surgery Shanghai Cancer Hospital Affiliated to Fu Dan UniversityShanghaiChina Department of General Surgery Fujian Medical University Union HospitalFuzhouChina Department of General Surgery The First Affiliated Hospital of Dalian Medical UniversityDalianChina Department

Objective:The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms(pNENs)undergoing surgery in ***:This is a multicenter cross-sectional study performed in *** from patients with pNENs undergoing surgery at 33 high-volume medical centers,where the number of pancreatectomies exceeds 20 cases per year,were collected and analyzed between March 1,2016 and February 28,***:In total,392 patients with pNENs were *** male to female ratio was *** majority of patients were aged between 40 and 70 years.65.6%of the patients had non-functional *** those with functional tumors,the percentages of insulinomas,gastrinomas,glucagonomas,and vasoactive intestinal peptide-secreting tumors were 94.8%,1.5%,2.2%,and 1.5%,*** team(MDT)discussion was conducted for 39.0%of the *** invasive surgery was performed on 31.1%of the 392 *** incidence of grade B/C pancreatic fistula formation was 4.4%.A total of 89.0%of the surgeries achieved R0 resection,and 41.6%of the tumors were well *** node metastasis was present in 8.9%of the *** percentages of patients with grades G1,G2,and G3 disease were 49.2%,45.7%,and 5.1%,***:This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in *** consultation for pNENs has not been widely implemented in *** the incidence of surgical complications is relatively low,minimally invasive procedures should be further *** study shows us how to improve the outcomes of these patients.

关键词： China Current status Pancreatic neuroendocrine neoplasms Pancreatic surgery

经腹腔入路腹腔镜腹膜后肿瘤切除术的临床疗效

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中华消化外科杂志 2018年第11期17卷 1116-1121页

作者：高晓杰黄鹤光陈燕昌陆逢春林贤超林荣贵杨媛媛方海宗王丛菲福建医科大学附属协和医院基本外科福州350001

目的：探讨经腹腔入路腹腔镜腹膜后肿瘤切除术的临床疗效。方法：采用回顾性横断面研究方法。收集2011年1月至2017年8月福建医科大学附属协和医院收治的37例行经腹腔入路腹腔镜腹膜后肿瘤切除术患者的临床病理资料。左季肋区腹膜后肿瘤... 详细信息

目的：探讨经腹腔入路腹腔镜腹膜后肿瘤切除术的临床疗效。方法：采用回顾性横断面研究方法。收集2011年1月至2017年8月福建医科大学附属协和医院收治的37例行经腹腔入路腹腔镜腹膜后肿瘤切除术患者的临床病理资料。左季肋区腹膜后肿瘤切除术入路借鉴腹腔镜胰体尾切除术，左髂区腹膜后肿瘤切除术入路借鉴腹腔镜左半结肠手术，右季肋区腹膜后肿瘤切除术入路可借鉴腹腔镜胰十二指肠切除术，右髂区腹膜后肿瘤切除术入路借鉴腹腔镜右半结肠手术。观察指标：（1）术中和术后恢复情况。（2）随访和生存情况。采用门诊和电话方式进行随访，了解患者术后肿瘤复发、转移和生存情况。随访时间截至2017年11月。正态分布的计量资料以±s表示，偏态分布的计量资料以M（范围）表示。结果：（1）术中和术后恢复情况：37例患者均顺利完成经腹腔入路腹腔镜腹膜后肿瘤切除术。其中4例患者中转开腹手术，4例取辅助小切口完成手术，4例联合行周围脏器切除术，其余25例患者行完全腹腔镜单纯腹膜后肿瘤切除术。37例患者手术时间为（181±73）min，术中出血量为（160±87）mL，术后胃肠功能恢复时间为（3.0±1.0）d，术后引流管拔除时间为（3.0±2.0）d。术后共3例患者发生并发症，包括乳糜漏 2例，胃排空障碍1例，均经对症处理后好转；无围术期死亡患者。37例患者术后住院时间为（7±4）d。（2）随访和生存情况：37例患者均获得术后随访，随访时间为3～82个月，中位随访时间为30个月。随访期间，1例炎性肌纤维母细胞瘤患者于术后15个月复发，再次行手术切除，二次手术后9个月出现肝转移，多次行介入手术治疗；1例Castleman病患者和5例淋巴瘤患者术后定期行化疗，无瘤生存；其余患者无瘤生存。结论：经腹腔入路腹腔镜腹膜后肿瘤切除术安全可行。

关键词：腹膜后肿瘤外科手术腹腔镜检查入路

胰腺癌患者及大鼠血清中microRNA-21和microRNA-155的表达及其意义

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中国普外基础与临床杂志 2018年第10期25卷 1171-1175页

作者：林贤超文实潘誉滕天鸿陈飞黄鹤光福建医科大学附属协和医院基本外科福州350001

目的探索胰腺癌患者和胰腺癌大鼠血清中microRNA(miRNA)-21和miRNA-155的表达水平及其用于胰腺癌诊断的价值。方法前瞻性收集2016年1月至2016年12月期间福建医科大学附属协和医院收治的18例胰腺癌患者(胰腺癌组)及同期收治的12例胰腺良... 详细信息

目的探索胰腺癌患者和胰腺癌大鼠血清中microRNA(miRNA)-21和miRNA-155的表达水平及其用于胰腺癌诊断的价值。方法前瞻性收集2016年1月至2016年12月期间福建医科大学附属协和医院收治的18例胰腺癌患者(胰腺癌组)及同期收治的12例胰腺良性疾病(胰腺良性疾病组)患者的临床资料和血清样本,采用实时荧光定量法检测血清中miRNA-21和miRNA-155的表达水平。同时建立20只由7, 12-二甲基苯并蒽(DMBA)诱导的胰腺癌大鼠模型,并设置对照(10只空白对照组大鼠行假手术),采集胰腺癌大鼠组(建模成功的胰腺癌大鼠)和空白对照组大鼠的血清,同法检测血清中miRNA-21和miRNA-155的表达水平。结果胰腺癌组患者血清中miRNA-21和miRNA-155的中位表达水平分别为1.99(1.43～5.30)和7.06(4.98～21.48),胰腺良性疾病组患者分别为1.28(0.58～2.01)和2.20(1.76～3.02),胰腺癌组患者的血清miRNA-21和miRNA-155表达水平均较高(Z=–2.621,P=0.009;Z=–3.430,P=0.001)。动物实验中,实验组建模成功并存活大鼠11只,空白对照组存活大鼠9只。胰腺癌大鼠组血清中miRNA-21和miRNA-155的中位表达水平分别为2.12(1.33～2.72)和16.45(7.18～25.40),空白对照组大鼠分别为1.00(0.45～1.60)和1.49(1.25～1.97),胰腺癌大鼠组血清中mi RNA-21和miRNA-155的表达水平均较高(Z=–2.621,P=0.009;Z=–3.609,P<0.001)。在区分胰腺癌和胰腺良性疾病方面,血清miRNA-21表达水平的最佳临界值为4.21,此时其灵敏度和特异度分别为75.0%和61.1%;血清miRNA-155表达水平的最佳临界值为4.67,此时其灵敏度和特异度均为83.3%。结论胰腺癌患者及大鼠血清中miRNA-21和miRNA-155的表达水平均异常升高,血清miRNA-155水平在一定程度上有助于区分胰腺癌与胰腺良性疾病。

关键词：胰腺癌诊断血清标志物 microRNA-21 microRNA-155

Consensus of clinical diagnosis and treatment for non-functional pancreatic neuroendocrine neoplasms with diameter<2 cm

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Journal of Pancreatology 2023年第3期6卷 87-95页

作者： Wu Wenming Cai Shouwang Chen Rufu Fu Deliang Ge Chunlin Hao Chunyi Hao Jihui huang heguang Jian Zhixiang Jin Gang Li Fei Li Haimin Li Shengping Li Weiqin LiYixiong Liang Tingbo Liu Xubao Lou Wenhui Miao Yi Mou Yiping Peng Chenghong Qin Renyi Shao Chenghao Sun Bei Tan Guang Wang Huaizhi Wang Lei Wang Wei Wang Weilin Wei Junmin Wu Heshui Wu Zheng Yan Changqing Yang Yinmo Yin Xiaoyu Yu Xianjun Yuan Chunhui Zhao Yupei Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Hepatobiliary Surgery PLA General HospitalBeijing 100853China Department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China Department of Hepatobiliary and Pancreatic Surgery Hunnan Division of The First Hospital of China Medical UniversityShenyang 110167China Department of Hepato-Pancreato-Biliary Surgery Peking University Cancer Hospital&InstituteBeijing 100142China Department of Pancreatic Cancer Tianjin Medical University Cancer Institute and HospitalTianjin 300060China Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510000China Department of Hepatobiliary Pancreatic Surgery Changhai Hospital Affiliated to Navy Medical University(Second Military Medical University)Shanghai 200433China Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China Department of Hepatobiliary Surgery Xijing HospitalFourth Military Medical UniversityXi’an 710032China Department of Hepatobiliary and Pancreatic Surgery Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China Department of Critical Care Medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China Department of General Surgery Xiangya HospitalCentral South UniversityChangsha 410008China Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department

In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small *** to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat *** response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert *** consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.

关键词： 2 cm Clinical diagnosis Non-functional pancreatic neuroendocrine neoplasms Treatment

腹腔镜经腹部分腹膜前修补术治疗下腹边缘疝的临床疗效

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中华消化外科杂志 2019年第11期18卷 1037-1042页

作者：潘茂恩黄鹤光陈燕昌陆逢春林贤超林荣贵杨媛媛王丛菲方海宗福建医科大学附属协和医院基本外科福州350001

目的探讨腹腔镜经腹部分腹膜前修补术(TAPE)治疗下腹边缘疝的临床疗效。方法采用回顾性描述性研究方法。收集福建医科大学附属协和医院2011年1月至2018年6月收治的58例下腹边缘疝患者的临床资料;男15例,女43例;年龄为(65±11)岁,年龄范... 详细信息

目的探讨腹腔镜经腹部分腹膜前修补术(TAPE)治疗下腹边缘疝的临床疗效。方法采用回顾性描述性研究方法。收集福建医科大学附属协和医院2011年1月至2018年6月收治的58例下腹边缘疝患者的临床资料;男15例,女43例;年龄为(65±11)岁,年龄范围为54~76岁。患者均行TAPE。观察指标:(1)术中及术后情况。(2)随访情况。采用门诊和电话方式进行随访,了解患者术后并发症发生情况。随访时间截至2018年8月。正态分布的计量资料以Mean±SD表示,计数资料以绝对数表示。结果(1)术中及术后情况:58例患者均顺利完成TAPE,术中测量疝环直径为(7.0±2.9)cm。58例患者中,因肠管与腹壁粘连严重6例,行杂交手术,术中行腹壁小切口分离粘连;复发疝2例,术中取出原补片后再行TAPE;术中探查发现合并左腹股沟直疝、右腹股沟斜疝和直疝各1例,均行同期修补术。58例患者手术时间为(153±46)min,术中出血量为(20±10)mL;术后不受麻醉限制即可下床活动,术后24 h进食流质食物,48 h进食半流质食物;术后住院时间为(3.8±1.1)d;腹带加压束缚3个月。(2)随访情况:58例患者均获得随访,术后随访时间为(22±19)个月。58例患者中7例发生术后并发症,其中血清肿3例,行细针穿刺抽吸积液+加压包扎后痊愈;肠梗阻2例,予禁食、胃肠减压、灌肠通便、抑制消化液分泌、补液营养等治疗后好转;Trocar疝1例,在全身麻醉下放置补片行无张力修补术后痊愈,未再复发;切口感染1例,予抗感染及换药处理后伤口愈合。其余患者随访期间均无复发、补片感染、慢性疼痛及尿频、尿急等并发症发生。结论TAPE治疗下腹边缘疝安全、有效。

关键词：疝边缘疝切口疝并发症腹膜前疝修补术补片修补术腹腔镜检查

The current surgical treatment of pancreatic cancer in China: a national wide cross-sectional study

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Journal of Pancreatology 2019年第1期2卷 16-21页

作者： Wenming Wu Gang Jin Chunyou Wang Yi Miao Huaizhi Wang Wenhui Lou Xianjun Yu Bei Sun Haimin Li Renyi Qin Zheng Wu Weilin Wang Kesen Xu Lei Wang Tingbo Liang Chunyi Hao heguang huang Yixiong Li Guang Tan Yongfu Zhao Jihui Hao Yifan Wang Chenghong Peng Xubao Liu Jinrui Ou Chunhui Yuan Xuefeng Wang Yinmo Yang Shouwang Ca Kejian Guo Jianxin Jiang Xiao Yu Junmin Wei Fei Li Xinmin Wu Yupei Zhao Pancreatic Surgery Study Group of Chinese Society of Surgery of Chinese Medical Association Medical College&Chinese Academy of Medical Sciences Beijing Department of PancreaticSurgery Shanghai Chang Hai Hospital affiliated to The Second Military MedicalUniversityShanghai Department of General Surgery Union Hospital Affiliated to TongjiMedical CollegeHuazhong University of Science&TechnologyWuhan Department ofGeneral Surgery Jiangsu Province HospitalThe First Affiliated Hospital to NanjingMedical UniversityNanjing Department of Hepato-Biliary-Pancreatic Surgery SouthwestHospitalThe First Hospital Affiliated to The Third Military Medical UniversityChongqing Department of Pancreatic Surgery Shanghai Zhongshan Hospital Affiliated to FuDan University Department of Pancreatic Surgery Shanghai Cancer Hospital Affiliated toFu Dan UniversityShanghai Department of General Surgery The First Affiliated Hospitalto Harbin Medical UniversityHarbin Department of Hepato-Biliary-Pancreatic Surgery Xijing Hospital Affiliated to the Fourth Military Medical UniversityXi’an Departmentof Pancreatic Surgery Tongji Hospital Affiliated to Tongji Medical CollegeHuazhongUniversity of Science&TechnologyWuhan Department of General Surgery The FirstAffiliated Hospital of Xi’an Jiao Tong UniversityXi’an Department of Hepato-Biliary-Pancreatic Surgery The First Affiliated HospitalZhejiang UniversityHangzhou Department of Pancreatic Surgery Qi Lu Hospital of Shandong UniversityJinan Department of Hepato-Biliary-Pancreatic Surgery The Second Affiliated HospitalZhejiangUniversityHangzhou Department of Hepato-Biliary-Pancreatic Surgery Beijing CancerHospital Affiliated to Peking UniversityBeijing Department of General Surgery FujianMedical University Union HospitalFuzhou Department of Pancreatic Surgery XiangyaHospital Affiliated to Central South UniversityChangsha Department of General Surgery The First Affiliated Hospital of Dalian Medical UniversityDalian Department ofHepato-Biliary-Pancreatic Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou Department of Pancreatic Surgery Tianjin Medical Un

Objective: The aim of this study is to investigate the current status of pancreatic cancer patients undoing surgical treatment in China and to find ways to improve the survival of these patients in the future. Methods: This study is a national, multicenter, cross-sectional study in China. Information regarding pancreatic cancer patients undergoing surgical treatment from 34 high-volume tertiary IIIA level hospitals was collected and analyzed from the March 1, 2016 to the February 28, 2017. Results: In total, 2200 pancreatic cancer patients were enrolled from 34 tertiary IIIA level hospitals in 16 provinces across China. The male-to-female ratio was 1.5. More than 80% of the patients were between 50 and 70 years old. The top 4 symptoms were epigastric discomfort, abdominal pain, jaundice, and weight loss. Carbohydrate antigen 19-9 and carcinoembryonic antigen were elevated in 70.9% and 27.1% of patients, respectively. A multidisciplinary team (MDT) discussion was carried out for 35.0% of patients before surgery. The proportion of minimally invasive pancreatic surgeries was approximately 20%. A total of 83.4% of the operations achieved R0 resection, and the incidence of grade 3/4 postoperative complications was 7.7%. Only 13.4% of the patients received postoperative adjuvant chemotherapy. The percentage of pathological stage I tumors was only 24.5%. Conclusion: The majority of pancreatic cancer patients undergoing surgical resection in China are in an advanced stage. The MDT consultations for pancreatic cancer have not been widely carried out. R0 resection has been achieved in most cases, with relatively low incidence of serious complications, but minimally invasive pancreatic surgery should be further promoted. The application of postoperative chemotherapy remains low. This national, multicentre, cross-sectional study comprehensively presents the current status of pancreatic cancer patients undergoing surgical treatment and shows the road to improve survival of these

关键词： China Current status Pancreatic cancer Pancreatic surgery Treatment

Guidelines for the diagnosis and treatment of acute pancreatitis in China (2021)

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Journal of Pancreatology 2021年第2期4卷 67-75页

作者： Fei Li Shouwang Cai Feng Cao Rufu Chen Deliang Fu Chunlin Ge Chunyi Hao Jihui Hao heguang huang Zhixiang Jian Gang Jin Ang Li Haimin Li Shengping Li Weiqin Li Yixiong Li Tingbo Liang Xubao Liu Wenhui Lou Yi Miao Yiping Mou Chenghong Peng Renyi Qin Chenghao Shao Bei Sun Guang Tan Xiaodong Tian Huaizhi Wang Lei Wang Wei Wang Weilin Wang Junmin Wei Heshui Wu Wenming Wu Zheng Wu Changqing Yan Yinmo Yang Xiaoyu Yin Xianjun Yu Chunhui Yuan Taiping Zhang Yupei Zhao on behalf of the Chinese Pancreatic Surgery Association Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing Department of Hepatobiliary and Pancreatic Surgery the First Medical CenterChinese PLA General HospitalBeijing Pancreatic Center Guangdong Provincial People’s HospitalGuangzhouGuangdong Province Department of Pancreatic Surgery Huashan HospitalFudan UniversityShanghai Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of China Medical UniversityShenyangLiaoning Province Department of Hepatopancreatobiliary Surgery Peking University Cancer HospitalBeijing Department of Pancreatic Cancer Tianjin Medical University Cancer Institute and HospitalTianjin Department of General Surgery Fujian Medical University Union HospitalFuzhouFujian Province Department of General Surgery Guangdong Provincial People’s HospitalGuangzhouGuangdong Province Department of Hepatobiliary Pancreatic Surgery Changhai Hospital Affiliated to Navy Medical UniversityShanghai Department of Hepatobiliary Surgery Xijing HospitalFourth Military Medical UniversityXi’anShaanxi Province Department of Pancreatobiliary Surgery Sun Yat-sen University Cancer CenterGuangzhouGuangdong Province Department of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjingJiangsu Province Department of General Surgery Xiangya HospitalCentral South UniversityChangshaHunan Province Department of Hepatobiliary and Pancreatic Surgery the First Affiliated Hospital of Medical CollegeZhejiang UniversityHangzhouZhejiang Province Department of Pancreatic Surgery West China HospitalSichuan UniversityChengduSichuan Province Department of General Surgery Zhongshan HospitalFudan UniversityShanghai Pancreas Center The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu Province Department of Gastrointestinal and Pancreatic Surgery Zhejiang Provincial People’s HospitalHangzhouZhejiang Province Department of General Surgery Pancreatic Disease CenterRuijin HospitalShanghai Jiao Tong University School of Med

Acute pancreatitis(AP)is a common acute abdominal condition of the digestive *** recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP *** the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and *** is expected to provide evidence support for the treatment of AP in the clinical setting in China.

关键词： Acute pancreatitis Diagnosis Follow-up Guideline Treatment

机器人食管裂孔疝修补联合胰腺中段切除、端端吻合术

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中华腔镜外科杂志（电子版） 2019年第4期12卷 243-245页

作者：高剑锋黄鹤光陈燕昌陆逢春林贤超方海宗福建医科大学附属协和医院基本外科

目的探讨利用机器人手术系统的优势联合进行食管裂孔疝无张力修补与胰腺中段切除、端端吻合术的可行性。方法优化胰腺中段切除的微创手术入路,利用机器人先行食管裂孔疝的疝内容物的松解复位、缩小裂孔、安放固定补片与胃底折叠术,随后... 详细信息

目的探讨利用机器人手术系统的优势联合进行食管裂孔疝无张力修补与胰腺中段切除、端端吻合术的可行性。方法优化胰腺中段切除的微创手术入路,利用机器人先行食管裂孔疝的疝内容物的松解复位、缩小裂孔、安放固定补片与胃底折叠术,随后继续进行胰腺中段切除,在近、远两端胰管内置入8号管后行胰腺端端吻合术。结果避免二次手术与减少手术操作孔数,术后患者恢复良好。复查CT显示胃底复位良好,胰腺肿瘤已切除,胰腺端端吻合处对位良好、支架管在位;术后病理提示近、远端切缘净。结论经文献检索,本病例报告是国内首例机器人经腹食管裂孔疝无张力修补、胃底折叠术联合胰腺中段切除、胰管成形、端端吻合术。本病例利用机器人联合手术治疗的成功有助于将来可能进行的多疾病联合手术治疗提供经验与思路。

关键词：机器人食管裂孔疝胰腺中段切除术