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胰头部占位性病变的病理学类型复杂多样,既包括胰腺导管腺癌等高度恶性肿瘤,也包括囊性肿瘤、内分泌肿瘤和炎性包块等低恶性和良性病变。目前国内处理胰头部占位性病变时,无论病理类型如何,对病灶的切除仍多沿用Whipple手术。对胰头部良性和低恶性病变实施Whipple手术,切除范围过大,代价太高,沿用Whipple手术治疗胰头部良性和低恶性病变所引起的学术讨论已成为胰腺外科的热点。主要介绍处理胰头良性和低恶性病变时可选择的胰腺肿瘤局部挖除术、保留十二指肠的胰头切除术和保留幽门的胰十二指肠切除术等保留器官手术的手术要点以及适应证,通过对上述术式的探讨,在胰头部良性和低恶性病变手术中推广器官保留与损伤控制的理念。
The pathological types of pancreatic head lesions occupy a complex and diverse, including both high-grade pancreatic ductal adenocarcinoma and malignant and benign lesions such as cystic tumors, endocrine tumors and inflammatory masses. At present, the treatment of lesions of the head of the pancreas in the country, regardless of the pathological type, removal of the lesion is still used more Whipple surgery. Whipple surgery on benign and malignant lesions of the pancreatic head, the scope of the resection is too large, the price is too high, the use of Whipple surgery for the treatment of benign and malignant lesions of the head of the pancreas academic discussions have become a hot topic in pancreatic surgery. Mainly introduced in the treatment of benign and malignant pancreatic lesions of the available choice of local pancreatic excision, retained duodenal resection of the pancreatectomy and retention of pylorus pancreaticoduodenectomy and other surgery to keep the main surgical procedures and Indications, through the discussion of the above surgical procedures, in the treatment of benign and malignant lesions of the head of the pancreas organ preservation and injury control concept.