中国实用外科杂志2026，Vol.46Issue(8)：1037-1041,5.DOI:10.19538/j.cjps.issn1005-2208.2026.08.05
精准解剖理念在胰腺癌根治术中实践与争议
Practice and controversies of the precise anatomy concept in radical resection for pancreatic cancer
摘要
Abstract
The quality of resection in radical surgery for pancreatic cancer directly affects patient prognosis.For a long time,extending the extent of resection was regarded as the main approach to achieving radical cure;however,its survival benefit has never been supported by high-quality evidence.In recent years,the concept of precise anatomy has gradually emerged in pancreatic surgery,emphasizing well-defined anatomical planes as the operative path and unified grading criteria for defining resection,making radical surgery a standardized procedure that can be described,assessed,and passed on.In the present era of continuous breakthroughs in systemic therapy,surgical precision has not been weakened;on the contrary,it has become increasingly important.The better the systemic control,the greater the impact of local resection quality on patient outcomes.Current evidence indicates that techniques,including total mesopancreas excision,the Heidelberg triangle operation,the arterial divestment technique,and radical antegrade modular pancreatosplenectomy(RAMPS),improve surrogate endpoints such as the R0 resection rate and local recurrence,whereas their benefit for overall survival remains unconfirmed.The value of the precise anatomy concept lies in establishing operative paradigms and anatomical standards,rather than in unlimited expansion of the resection extent.Exercising restraint where evidence is lacking and pursuing standardization where standards exist represent the true significance of the precise anatomy concept in radical surgery for pancreatic cancer.关键词
胰腺外科/精准解剖/胰腺系膜/海德堡三角/肿瘤根治性Key words
pancreatic surgery/precise anatomy/mesopancreas/Heidelberg triangle/tumor radicality分类
医药卫生引用本文复制引用
张太平,罗文浩,刘悦泽,邱江东,曹喆..精准解剖理念在胰腺癌根治术中实践与争议[J].中国实用外科杂志,2026,46(8):1037-1041,5.基金项目
National Key R&D Program of China(No.2023YFC2413400) （No.2023YFC2413400）
National Natural Science Foundation of China(No.82473086) （No.82473086）
National High Level Hospital Clinical Research Funding(No.2025-PUMCH-A-070) （No.2025-PUMCH-A-070）
China Postdoctoral Science Foundation(No.2026T190535) 国家重点研发计划项目(No.2023YFC2413400) （No.2026T190535）
国家自然科学基金项目(No.82473086) （No.82473086）
国家高水平医院临床研究项目(No.2025-PUMCH-A-070) （No.2025-PUMCH-A-070）
中国博士后科学基金资助项目(No.2026T190535) （No.2026T190535）
