关键词: 腹腔镜, 胰十二指肠切除术, 手术入路

Abstract: Approach strategy for difficult laparoscopic pancreaticoduodenectomy        YU Min, ZHANG Ding-wen, LIN Qing, et al. Guangdong Provincial Peoples Hospital; Guangdong Academy of Medical Sciences; South China Pancreatic Center，Guangzhou 510000，China
Corresponding author：CHEN Ru-fu，E-mail：chenrf63@163.com
Abstract    Laparoscopic pancreaticoduodenectomy has the characteristics of complicated operation，long learning period and high surgical risk. At present，there is still a lack of accurate definition of difficult pancreaticoduodenectomy.Based on many years of surgical experience，the author divides difficult pancreaticoduodenectomy into difficulty in tumor resection and difficulty in gastrointestinal reconstruction.In view of the difficulty of tumor resection，a comprehensive evaluation should be carried out based on the patient's condition before surgery，and a reasonable surgical approach should be selected based on the experience of the surgeon during the operation.For the difficulty of gastrointestinal reconstruction，a reasonable pancreaticojejunostomy should be selected according to the surgical method，the texture of the pancreatic stump and the inner diameter of the main pancreatic duct.

Key words: laparoscopy, pancreaticoduodenectomy, surgical approach