摘要
肝胆外科正处于以精准医学为导向的数字化转型阶段。人工智能（AI）可用于预测术后并发症、复发风险及生存结局，从而重塑手术规划与决策模式；三维可视化及增强现实技术实现解剖结构实时导航，提升复杂手术的精准性与安全性；大数据分析推动多中心长期预后研究，为优化治疗策略提供循证医学依据。精准医学通过整合基因组特征与解剖学因素，指导个体化手术范围及辅助治疗选择。异种肝移植的进展虽拓展了供体来源，但跨物种感染与免疫排斥仍需基因编辑及伦理审查应对。AI主导的术中导航与机器人手术对传统外科角色提出挑战，而“数字鸿沟”、数据标准化不足及监管缺失则限制了技术的广泛应用。未来研究应依托高质量临床试验验证新技术效能，建立跨机构统一的数据标准，并在推动技术创新的同时坚守外科人文核心（包括临床判断力与病人安全），以确保数字化转型真正实现病人预后的最大化改善。
Abstract
Hepatobiliary surgery is undergoing a digital transformation guided by the principles of precision medicine. Artificial intelligence (AI) can be applied to predict postoperative complications, recurrence risk, and survival outcomes, thereby reshaping surgical planning and decision-making paradigms. Three-dimensional visualization and augmented reality technologies enable real-time navigation of anatomical structures, improving the precision and safety of complex surgical procedures. Big data analytics facilitate multicenter, long-term prognostic studies, providing evidence-based guidance for optimizing treatment strategies. Precision medicine integrates genomic features with anatomical factors to guide individualized determination of surgical extent and adjuvant therapy selection. Advances in xenogeneic liver transplantation have expanded the donor pool; however, the risks of cross-species infection and immune rejection require mitigation through gene-editing technologies and robust ethical oversight. AI-driven intraoperative navigation and robotic surgery challenge the traditional role of surgeons, while the “digital divide”, insufficient data standardization, and lack of regulatory frameworks continue to hinder widespread implementation. Future research should rely on high-quality clinical trials to validate the efficacy of emerging technologies, establish standardized data-sharing frameworks across institutions, and, while promoting technological innovation, uphold the core humanistic values of surgery—including clinical judgment and patient safety—to ensure that digital transformation ultimately maximizes improvements in patient outcomes.
关键词
肝胆外科 /
精准医学 /
人工智能 /
数字化转型 /
手术决策优化
Key words
hepatobiliary surgery /
precision medicine /
artificial intelligence /
digital transformation /
surgical decision-making optimization
徐家豪1, 周琛曜2, 杨 田1.
肝胆外科研究的未来：精准医学时代的数字化转型之路[J]. 中国实用外科杂志. 2025, 45(09): 985-988 https://doi.org/10.19538/j.cjps.issn1005-2208.2025.09.04
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