胰腺癌围术期热点问题与管理策略
Perioperative Hot Issues and Management Strategies for Pancreatic Cancer
刘伟康 1陈依然 1杨尹默1
作者信息
- 1. 北京大学第一医院肝胆胰外科,北京 100034
- 折叠
摘要
胰腺癌恶性度高、早期诊断率低、整体预后差.首诊患者中仅 15%～20%为可切除胰腺癌,20%～30%为交界可切除胰腺癌,50%以上为不可切除胰腺癌.手术切除是目前唯一可能治愈胰腺癌的治疗方式,但由于胰头部解剖部位特殊,手术切除后需进行复杂的消化道重建,术后易并发B/C级胰瘘、出血等严重并发症.充分的术前准备、个体化的术后管理对于减少围术期并发症,提高患者生活质量,术后尽早开展辅助治疗至关重要.本文结合文献和临床诊疗实践,对胰腺癌患者围术期若干热点问题,包括营养支持与心理支持、术前减黄、新辅助治疗、胰瘘和术后出血的预防与处理策略等展开论述,以期提高临床同行对胰腺癌的认知,改善患者临床结局,提高总体生存率.
Abstract
Pancreatic cancer is characterized by high malignancy,low early diagnosis rates,and poor prognosis.Approximately 15%-20%of patients at initial diagnosis have resectable pancreatic cancer,20%-30%have borderline resectable pancreatic cancer,and over 50%are present with unresectable.Surgical resec-tion remains the only potentially curative treatment option available,but the unique anatomical position of the pancreatic head necessitates complex gastrointestinal reconstruction after resection,which may lead to severe complications such as grade B/C pancreatic fistulas and bleeding.Comprehensive preoperative preparation and individualized postoperative management are crucial to reducing perioperative complications,enhancing patient quality of life,and expediting the initiation of adjuvant therapy.This article reviews perioperative integrated management strategies for patients with pancreatic cancer,drawing on literature and our center's experience,in-cluding nutritional therapy,psychological support,preoperative jaundice reduction,neoadjuvant treatment,the prevention and management of pancreatic fistulas and postoperative bleeding,with the aim of improving clinical outcomes and overall survival rates.
关键词
胰腺癌/围术期/热点问题/手术切除Key words
pancreatic cancer/perioperative/key issues/surgical resection引用本文复制引用
基金项目
国家自然科学基金(82171722)
国家自然科学基金(82271764)
国家自然科学基金(81871954)
北京市自然科学基金(7212111)
出版年
2024
国家科技期刊平台
NSTL
万方数据