腹腔镜胰十二指肠切除术的优劣势及未来发展方向

腹腔镜胰十二指肠切除术(LPD)被认为是最具挑战性的腹部手术之一,自1994年首例报道以来,已发展近25年,在最初10年由于受到广泛的争议与反对而发展缓慢。近10年来,随着高清腹腔镜普及应用、腹腔镜操作器械的不断改进、微创手术的发展、患者选择的改善以及开腹胰十二指肠切除术经验的不断积累,LPD得到了突破性的发展。但是目前在外科界关于LPD的争议仍有很多,本文就LPD对比开腹胰十二指肠切除术在适应证、学习曲线、并发症、短期效益、长期肿瘤学结果、成本等方面的优劣势及未来发展方向做一综述。

Laparoscopic Pancreaticoduodenectomy:Strength,Weakness,and Future Directions

Laparoscopic pancreatoduodenectomy(LPD)is one of the most challenging abdominal procedures.It has been developed for nearly 25 years since the first report in 1994.During the first 10 years,LPD has developed slowly due to widespread controversy and opposition.In the past 10 years,a number of breakthroughs have been made in LPD with the introduction of high-definition laparoscopy,improvements in laparoscopic instruments,advances in minimally invasive surgery,improved selections of patients,and accumulation of experiences in open pancreaticoduodenectomy(OPD).However,many controversies still exist.This review summarizes the strength and weakness of LPD versus OPD in terms of indications,learning curve,complications,short-term benefits,long-term oncology results,and cost and proposes its future directions.