中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (01): 83-89.DOI: 10.19538/j.cjps.issn1005-2208.2023.01.11

• 专家论坛 • 上一篇    下一篇

精准肝胆外科技术体系在复杂胆道外科的应用

陈志宇，何    宇，张雷达，郑树国，王小军，戴海粟，刘智鹏，杨宜恃   

  1. 陆军军医大学第一附属医院（西南医院）肝胆外科 全军肝胆外科研究所，重庆400038
  • 出版日期:2023-01-01 发布日期:2023-01-19

  • Online:2023-01-01 Published:2023-01-19

摘要： 胆道外科是腹部外科中最复杂、预后最差的领域之一，其根源在于胆道作为一个器官，承载着丰富的生理功能、复杂的解剖变异，以及自身的脆弱性。胆道外科的复杂性不仅在于手术操作层面，更是体现在诊疗的全流程，包括术前评估、术中操作及术后管理。以最大化目标病灶清除、最大化肝脏功能保护、最小化创伤侵袭为目标的精准肝胆外科技术体系，以病人利益最大化为价值观，定位、定量、定构技术为核心，开创了现代胆道外科的新起点。在此基础上，提出了“病变胆管树流域”切除为核心的胆道外科理念，针对胆道疾病创新评估手段及术式，以期更加精准地指导临床实践，提高胆道外科的确定性。

关键词: 精准肝胆外科, 胆道外科, 病变胆管树流域

Abstract: Application of precision hepatobiliary surgery technology system in complex biliary surgery        CHEN Zhi-yu,HE Yu,ZHANG Lei-da,et al. Hepatobiliary Surgery, the First Affiliated Hospital of Army Medical University (Southwest Hospital)；The Institute of Hepatobiliary Surgery of the Army, Chongqing400038,China
Corresponding author：CHEN Zhi-yu, E-mail：chenzhiyu_umn@
163.com
Abstract    Biliary surgery is one of the most complex and poorly prognosed areas of abdominal surgery, rooted in the fact that the biliary tract, as an organ, carries a wealth of physiological functions, complex anatomical variations, and its own vulnerability. The complexity of biliary surgery is not only at the level of surgical operations, but also in the whole process of diagnosis and treatment, including preoperative assessment, intraoperative operation and postoperative management. The precision hepatobiliary surgery technology system, which aims at maximizing the removal of target lesions, maximizing liver protection and minimizing trauma invasion, taking the maximization of patient interests as the value and positioning, quantification, and stereotyping technology as the core, has created a new starting point for modern biliary surgery. On this basis, we put forward the concept of biliary surgery with the core of "diseased biliary tree territory" resection, and proposed innovative evaluation methods and procedures for biliary diseases, in order to guide clinical practice more accurately and improve the certainty of biliary surgery.

Key words: precision hepatobiliary surgery , biliary surgery, diseased biliary tree