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中华腔镜外科杂志(电子版) ›› 2025, Vol. 18 ›› Issue (02) : 65 -72. doi: 10.3877/cma.j.issn.1674-6899.2025.02.001

指南与共识

胰管(修复)外科专家共识
中国研究型医院学会微创外科专业委员会1, 中国研究型医院学会智能医学专业委员会1   
  1. 1. 100853 北京,解放军总医院第一医学中心肝胆胰外科医学部
  • 收稿日期:2025-03-11 出版日期:2025-04-30
  • 基金资助:
    科技创新2030-“新一代人工智能”重大项目(2021ZD0113301)

Expert consensus on pancreatic duct (repair) surgery

Minimally Invasive Surgery Professional Committee of the Chinese Research Hospital Association The1, Intelligent Medicine Professional Committee of the Chinese Research Hospital Association The1   

  1. 1. Faculty of Hepato-Pancreato-Biliary Surgery,the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2025-03-11 Published:2025-04-30
引用本文:

中国研究型医院学会微创外科专业委员会, 中国研究型医院学会智能医学专业委员会. 胰管(修复)外科专家共识[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(02): 65-72.

Minimally Invasive Surgery Professional Committee of the Chinese Research Hospital Association The, Intelligent Medicine Professional Committee of the Chinese Research Hospital Association The. Expert consensus on pancreatic duct (repair) surgery[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2025, 18(02): 65-72.

为规范和推广胰管(修复)外科技术在胰腺良性及交界/低度恶性肿瘤手术中的应用,提高术后疗效并降低并发症风险,制定本专家共识。

方法

由中国研究型医院学会微创外科专业委员会和智能医学专业委员会组织国内胰腺外科专家,结合文献证据与临床实践,围绕胰管解剖、修复外科概念、手术适应证、术前评估、术中操作及术后管理展开讨论,形成共识建议。

结果

共识明确了胰管修复外科的核心技术,包括主胰管修复术、胰腺端-端对拢重建术、主胰管替代术及分支胰管型导管内乳头状黏液性肿瘤(branch-duct intraductal papillary mucinous neoplasm, BD-IPMN)局部切除术。强调术前多模态影像学评估、术中超声引导和微创技术的应用,推荐根据胰管损伤程度选择修复方式,并规范了胰管支撑管的使用及术后胰瘘防治策略。

结论

胰管(修复)外科通过恢复胰管连续性,避免了传统消化道重建,显著降低了术后胰瘘和出血风险,是胰腺功能保留手术的重要进展。未来需进一步验证其长期疗效并优化技术细节。

Objective

To standardize and promote the clinical application of pancreatic duct(repair) surgery for benign and borderline/low-grade malignant pancreatic tumors, thereby improving surgical outcomes and reducing complications, this expert consensus was formulated.

Methods

Organized by the Minimally Invasive Surgery Committee and Intelligent Medicine Committee of the Chinese Research Hospital Association, domestic pancreatic surgery experts discussed key topics including pancreatic duct anatomy, repair concepts, surgical indications, preoperative evaluation, intraoperative techniques, and postoperative management, integrating literature evidence and clinical experience.

Results

The consensus delineates core techniques of pancreatic duct repair surgery, such as main pancreatic duct repair, end-toend pancreatic anastomosis, main pancreatic duct replacement, and branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) local resection. It emphasizes preoperative multimodal imaging evaluation,intraoperative ultrasound guidance, and minimally invasive approaches. Recommendations include selecting repair strategies based on duct injury severity, standardized use of pancreatic stents, and postoperative pancreatic fistula prevention protocols.

Conclusion

Pancreatic duct (repair) surgery restores duct continuity, avoids traditional gastrointestinal reconstruction, and significantly reduces postoperative complications. It represents a major advancement in organ-preserving pancreatic surgery. Further studies are needed to validate long-term efficacy and refine technical details.

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