腹腔镜肝胆胰脾手术策略与技巧

Surgical strategies and techniques of laparoscopic surgery in hepatobiliary, splenic and pancreatic diseases

  • 摘要: 腹腔镜肝胆胰脾手术临床应用日益广泛,但该类手术复杂,术后并发症发生率高。术者应熟悉正常解剖与变异,熟练掌握术中出血的预防与处理,针对不同组织特点,采用不同离断方法。另外消化道重建是腹腔镜肝胆胰手术的技术瓶颈与难点,强调学习曲线与团队配合,并根据患者具体病情选择不同的吻合方式。3D腹腔镜及达芬奇手术机器人手术系统的应用极大地促进了复杂腹腔镜肝胆胰脾手术的发展与应用。围术期的综合管理及术后加速康复理念的应用是患者术后安全快速康复的保障,进而充分体现微创外科的优势。

     

    Abstract: Laparoscopic surgery in hepatobiliary, splenic and pancreatic diseases is being widely used. However, the incidence of postoperative complications is relatively higher due to the complexity of the operative procedures. Surgeons are expected to have familiarity with normal and variant anatomy, as well as a good command of prevention and management of bleeding. Different separation techniques should be used based on the different characteristics of tissues. Moreover, digestive tract reconstruction is the technical bottleneck in laparoscopic hepatobiliary, splenic and pancreatic surgeries, and depending on the team work. Different anastomotic methods should be applied according to patients′ condition. Threedimensional laparoscopy and Da Vinci robot surgical system have greatly promoted the development of complex laparoscopic surgery in hepatobiliary, splenic and pancreatic surgeries. Comprehensive perioperative management and enhanced recovery after surgery are the guarantee of safe and quick postoperative recovery, which also fully embody the advantages of minimally invasive surgery.

     

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