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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (05): 301 -306. doi: 10.3877/cma.j.issn.1674-6899.2019.05.011

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胰十二指肠切除术中静脉切除重建的研究现状
朱春宇 1, 刘荣 1 , †( )   
  1. 1. 100853 北京，解放军总医院第一医学中心肝胆外二科
  • 收稿日期:2019-08-29 出版日期:2019-10-30
  • 通信作者: 刘荣

The research status of vein resection and reconstruction in pancreatoduodenectomy

Chunyu Zhu 1, Rong Liu 1 , †( )   

  1. 1. The Second Department of Hepatobiliary Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2019-08-29 Published:2019-10-30
  • Corresponding author: Rong Liu
  • About author:
    Corresponding author: Liu Rong, Email:
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胰腺癌是一种恶性肿瘤，可接受治愈性手术的患者较少，静脉切除是获取切缘阴性与扩大手术人群的有效方式。外科医师主要通过术前影像学检查与患者特征决定是否在胰十二指肠切除术(pancreaticoduodenectomy，PD)中同时行相关静脉的切除及重建。切除肿瘤侵犯的静脉重建方式有多种选择，主要由肿瘤与静脉间的关系与手术医师的选择有关。PD合并静脉切除重建后可能会带来切缘阳性增多、并发症发生率升高等新的问题。辅助治疗已经成为胰腺癌的标准治疗方案，新辅助治疗在静脉受侵犯时的作用也受到认可。基因组学与信息化技术可能会为未来的手术及术后综合治疗提供新的诊疗方式。

关键词: 胰腺癌, 胰十二指肠切除术, 门静脉

Pancreatic cancer is a malignant tumor, and the number of patients who can receive curable surgery is small. Therefore, venectomy is an effective way to obtain negative surgical margins and expand the surgical population. The surgeon determines whether to perform simultaneous resection and reconstruction of the relevant vein during pancreaticoduodenectomy by preoperative imaging examination and patient characteristics. There are many options for reconstructing the vein after tumor resection, which are mainly related to the relationship between tumor and vein and the choice of surgeon. Pancreatoduodenectomy combined with venous resection and reconstruction may lead to more positive surgical margins and higher incidence of complications. Adjuvant therapy has become the standard treatment for pancreatic cancer, and neoadjuvant therapy is recognized for its role in venous invasion. Genomics and information technology may provide a new way of diagnosis and treatment for future surgery and postoperative comprehensive treatment.

Key words: Pancreatic cancer, Pancreaticoduodenectomy, Portal vein
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