关键词: 腹腔镜, 胰十二指肠切除术, 困难情况, 手术入路, 血管重建

Abstract: Precise evaluation and Countermeasures of difficult laparoscopic pancreaticoduodenectomy        CHEN Ru-fu,ZHOU Yu. Pancreatic Center, Department of General Surgery, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
Corresponding author: CHEN Ru-fu,E-mail: chenrufu@mail.sysu.edu.cn
Abstract    Laparoscopic pancreaticoduodenectomy has high technical requirements. According to the author’s own experience, the difficult pancreaticoduodenectomy was divided into two categories: difficult tumor resection and difficult digestive tract reconstruction. Combined with preoperative imaging and intraoperative exploration, fully evaluate the factors such as general condition, tumor size, tumor location, the relationship between tumor and blood vessel, regional adhesion, main vascular variation, pancreatic texture, the diameter of the pancreatic duct and bile duct, formulate individualized resection strategy, flexibly use a variety of surgical approaches, take safety and radical cure as the core, and formulate operation strategy in combination with their own experience and technical characteristics during operation.

Key words: laparoscope, pancreaticoduodenectomy, difficult situations, surgical approach, vascular reconstruction