中国普通外科杂志2025，Vol.34Issue(9)：1876-1881,6.DOI:10.7659/j.issn.1005-6947.250479
预防性胆-胰双分流:胰十二指肠切除术后并发症防控的理念革新与临床转化
Prophylactic dual biliary-pancreatic diversion:a conceptual and translational innovation in preventing postoperative complications after pancreaticoduodenectomy
摘要
Abstract
Pancreaticoduodenectomy(PD)remains one of the most complex and high-risk procedures in abdominal surgery,with clinically relevant postoperative pancreatic fistula(CR-POPF)being a significant determinant of morbidity and mortality.Recent evidence suggests that merely modifying the pancreatoenteric anastomosis technique fails to achieve a consistent reduction in fistula incidence.The Department of Pancreatic Surgery at Zhongshan Hospital,Fudan University,has developed a prophylactic dual biliary-pancreatic diversion system that simultaneously drains bile and pancreatic juice during PD.This system provides dual protection through"decompression and separation,"preventing premature activation of pancreatic enzymes and reducing anastomotic stress.This article introduces the system's conceptual framework,design principles,and clinical application,summarizes ongoing multicenter randomized controlled trials,and discusses key issues,including indication selection,intraoperative management,external drainage care,and patient compliance.Furthermore,it outlines future directions in risk stratification,antimicrobial stewardship,intelligent drainage,and biomaterial innovation.As a conceptual and translational advance,this dual diversion strategy may redefine the paradigm of postoperative complication prevention after PD.关键词
胰十二指肠切除术/胰腺瘘/预防性胆-胰双管分流Key words
Pancreaticoduodenectomy/Pancreatic Fistula/Prophylactic Dual Biliary-Pancreatic Diversion分类
临床医学引用本文复制引用
韩序,王文权,刘亮..预防性胆-胰双分流:胰十二指肠切除术后并发症防控的理念革新与临床转化[J].中国普通外科杂志,2025,34(9):1876-1881,6.基金项目
国家自然科学基金资助项目(82273382) （82273382）
上海市白玉兰人才计划浦江基金资助项目(24PJD012) （24PJD012）
希思科—恒瑞肿瘤研究基金项目青年基金资助项目(Y-HR2022QN-0085). （Y-HR2022QN-0085）
