Abstract:

The technique and tips of laparoscopic pancreaticoduodenectomy        HONG De-fei. Department of Hepatobiliary and Pancreatic Surgery，Minimally Invasive Surgery，Zhejiang Provincial People’s Hospital，Hangzhou 310014，China
Abstract    Laparoscopic pancreaticoduodenectomy is eventually gaining momentum after 10 years’ development of laparoscopic surgical skills and endoscopic surgical devices. Some large volume minimal invasive pancreatic surgery centers have proved that LPD had same short and long-term outcomes compared with OPD，and shown some minimal invasive benefits than traditional OPD. In our country，less than 10 surgical centers have experience of more than 100 cases of LPD，most of the traditional large volume pancreatic centers are not interested in performing LPD. However, most of the surgeons who perform LPD are in small volume pancreatic centers with potential high risks of postoperative mortality and morbidity. To reduce the risks of LPD during the learning curve period，it is important to standardize the surgical procedure and perioperative treatment of these patients.

Key words: pancreaticoduodenectomy, laparoscopic, indication, learning curve

摘要：

近10年来，随着腹腔镜手术经验的不断积累和高清腹腔镜、超声刀、内镜切割闭合器等的普及应用，腹腔镜胰十二指肠切除术（laparoscopic pancreaticoduodenectomy，LPD）发展较快，多数大中心的大样本研究数据表明其近、远期效果与开腹胰十二指肠切除术（open pancreaticoduodenectomy，OPD）相近甚至更优。我国极少数医院的胰腺外科中心已完成了超过百例的LPD，但多数大型胰腺外科中心仍以OPD为主，反而不少地市级医院热衷于开展LPD，其中多数医院处于具有潜在风险的学习曲线期。因此，亟待总结和充分交流开展LPD的经验，加强围手术期管理和规范手术操作，降低和规避学习曲线期的风险。

关键词: 胰十二指肠切除术, 腹腔镜, 适应证, 学习曲线