Abstract: Progress and directions in clinical research on laparoscopic pancreaticoduodenectomy        QIN Ren-yi, PENG Feng. Department of Biliary-Pancreatic Surgery, the Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan 430030, China
Corresponding author: QIN Ren-yi,E-mail:ryqin@tjh.tjmu.edu.cn
Abstract    Laparoscopic pancreaticoduodenectomy (LPD) is one of the new technologies and academic hotspots in hepatobiliary and pancreatic surgery. LPD is safe, feasible, and has certain advantages in some aspects in large hospitals and for experienced surgeons. At the current level of evidence, LPD is not an equivalent alternative to open pancreaticoduodenectomy. Although LPD requires a longer surgical time, it can significantly reduce blood loss and reduce postoperative hospital stay and serious complications. Although the LPD learning curve is long, there are many ways surgeons can speed up the learning curve. Further research should focus on training programs in pancreatic surgery and laparoscopic surgery techniques at the large scale pancreatic surgery center to safely overcome the adverse effects of the learning curve through adequate training, guidance and supervision, as well as precise patient selection. In addition, it is necessary to further study the technical details and surgical approaches of LPD in the low-volume center, so as to avoid the influence of the central volume and further promote the technology of LPD.

Key words: laparoscopic pancreaticoduodenectomy, clinical research

摘要： 腹腔镜胰十二指肠切除术（LPD）是目前国内外肝胆胰外科的新技术和学术热点之一，在大型医院和对于有经验的外科医生，LPD安全可行且在某些方面具有一定的优势。就目前的证据水平而言，LPD尚不能作为一个开放胰十二指肠切除术的等效替代方案。尽管LPD需要更长的手术时间，但是可显著减少出血量，并且可以减少术后住院时间和严重并发症。尽管LPD学习曲线漫长，但是有很多途径可以帮助外科医生加速度过学习曲线。进一步的研究重点应放在大体量胰腺外科中心中进行相应的培训计划，包括胰腺外科手术与腹腔镜手术技巧，通过充分的培训、指导和监督措施，以及精准的病人选择，以安全克服学习曲线带来的不利影响。此外，需要进一步在低体量中心开展LPD的技术细节和手术入路研究，从而避免中心体量的影响，进而真正的将LPD的技术进一步推广。

关键词: 腹腔镜胰十二指肠切除术, 临床研究