《腹腔镜或机器人辅助胰腺癌根治术中国专家共识（2022 年版）》是由中国抗癌协会胰腺癌专业 委员会微创诊治学组与中华医学会外科学分会胰腺外科学组组织全国部分胰腺外科专家制定，2022 年首次发表于 Journal of Pancreatology。在此共识中，相关专家针对腹腔镜或机器人辅助手术的安全性、肿瘤学获益、学习曲线及 挑战性等方面做了详细阐述，旨在为腹腔镜或机器人辅助手术治疗胰腺癌的临床应用提供参考与指导意见。

Chinese expert consensus on laparoscopic or robot-assisted radical pancreatectomy for pancreatic cancer (2022 Edition) was first published in the Journal of Pancreatology in 2022. It is formulated by Study Group of Minimally Invasive Treatment for Pancreatic Cancer in China Anti-Cancer Association and Chinese pancreatic surgery association (CPSA), Chinese Society of Surgery, Chinese Medical Association referring to Chinese expert opinions and relevant researches in the world. This article is an interpretation of the consensus. The consensus addresses the safety, oncological benefits, learning curve, and challenging aspects of laparoscopic/robot-assisted surgery, providing a reference and guidance for the clinical application of laparoscopic/robot-assisted surgery in the treatment of pancreatic cancer.

收稿日期：2023-08-03  录用日期：2023-11-03 

Received Date: 2023-08-03  Accepted Date: 2023-11-03 

基金项目：上海市科委科技创新行动计划（20Y11908600） 

Foundation Item: Science and Technology Inovation Action Plan of Shanghai Science and Technology Commission (20Y11908600) 

通讯作者：姜翀弋，Email：jiangzhongyi9@126.com 

Corresponding Author: JIANG Chongyi, Email: : jiangzhongyi9@126.com 

引用格式：蔡志伟，姜翀弋 .《腹腔镜或机器人辅助胰腺癌根治术中国专家共识（2022年版）》解读 [J]. 机器人外科学杂志（中英文）， 2024，5（2）：299-303. 

Citation: CAI Z W, JIANG C Y. Interpretation of Chinese expert consensus on laparoscopic or robot-assisted radical pancreatectomy for pancreatic cancer (2022 edition)[J]. Chinese Journal of Robotic Surgery, 2024, 5(2): 299-303

[1] Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy[J]. Surg Endosc, 1994, 8(5): 408-410. 

[2] Cuschieri A. Laparoscopic surgery of the pancreas[J]. J R Coll Surg Edinb, 1994, 39(3): 178-184. 

[3] Giulianotti P C, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital[J]. Arch Surg, 2003, 138(7): 777- 784. 

[4] Melvin W S, Needleman B J, Krause K R, et al. Robotic resection of pancreatic neuroendocrine tumor[J]. J Laparoendosc Adv Surg Tech A, 2003, 13(1): 33-36. 

[5] FENG Q, LIAO W, XIN Z, et al. Laparoscopic pancreaticoduodenectomy versus conventional open approach for patients with pancreatic duct adenocarcinoma: an Up-to-Date systematic review and meta-analysis[J]. Front Oncol, 2021. DOI: 10.3389/ fonc.20201.749140. 

[6] PENG L, LIN S, LI Y, et al. Systematic review and Meta-analysis of robotic versus open pancreaticoduodenectomy[J]. Surg Endosc, 2017, 31(8): 3085-3097. 

[7] Vining C C, Kuchta K, Schuitevoerder D, et al. Risk factors for complications in patients undergoing pancreaticoduodenectomy: a NSQIP analysis with propensity score matching[J]. J Surg Oncol, 2020, 122(2): 183-194. 

[8] LIU Q, ZHAO Z, ZHANG X, et al. Perioperative and oncological outcomes of robotic versus open pancreaticoduodenectomy in low-risk surgical candidates: a multicenter propensity score-matched study[J]. Ann Surg, 2023, 277(4): e864-e871. 

[9] van Hilst J, De Rooij T, Klompmaker S, et al. Minimally invasive versus open distal pancreatectomy for ductal adenocarcinoma (DIPLOMA): a pan-european propensity score matched study[J]. Ann Surg, 2019, 269(1): 10-17. 

[10] Korrel M, Jones L R, van Hilst J, et al. Minimally invasive versus open distal pancreatectomy for resectable pancreatic cancer (DIPLOMA): an international randomised non-inferiority trial[J]. Lancet Reg Health Eur, 2023. DOI: 10.1016/j.lanepe. 2023.100673. 

[11] CHEN K, ZHOU Y, JIN W, et al. Laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic outcomes and long-term survival[J]. Surg Endosc, 2020, 34(5): 1948-1958. 

[12] YIN Z, JIAN Z, HOU B, et al. Surgical and oncological outcomes of laparoscopic versus open pancreaticoduodenectomy in patients with pancreatic duct adenocarcinoma[J]. Pancreas, 2019, 48(7): 861-867. 

[13] Uijterwijk B A, Wei K, Kasai M, et al. Minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma: individual patient data meta-analysis of randomized trials[J]. Eur J Surg Oncol, 2023, 49(8): 1351-1361.

[14] JIANG Y L, ZHANG R C, ZHOU Y C. Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and Metaanalysis[J]. BMC Cancer, 2019, 19(1): 781. 

[15] Nassour I, Choti M A, Porembka M R, et al. Roboticassisted versus laparoscopic pancreaticoduodenectomy: oncological outcomes[J]. Surg Endosc, 2018, 32(6): 2907-2913.

[16] Nassour I, Winters S B, Hoehn R, et al. Long-term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma[J]. J Surg Oncol, 2020, 122(2): 234-242. 

[17] Raoof M, Ituarte P H G, Woo Y, et al. Propensity scorematched comparison of oncological outcomes between laparoscopic and open distal pancreatic resection[J]. Br J Surg, 2018, 105(5): 578-586. 

[18] Ricci C, Casadei R, Taffurelli G, et al. Laparoscopic versus open distal pancreatectomy for ductal adenocarcinoma: a systematic review and metaanalysis[J]. J Gastrointest Surg, 2015, 19(4): 770-781.

[19] Magistri P, Boggi U, Esposito A, et al. Robotic vs open distal pancreatectomy: a multi-institutional matched comparison analysis[J]. J Hepatobiliary Pancreat Sci, 2021, 28(12): 1098-1106. 

[20] Duran H, Ielpo B, Caruso R, et al. Does robotic distal pancreatectomy surgery offer similar results as laparoscopic and open approach? A comparative study from a single medical center[J]. Int J Med Robot, 2014, 10(3): 280-285. 

[21] Lee S Y , Allen P J , Sadot E , et al. Distal pancreatectomy: a single institution’s experience in open, laparoscopic, and robotic approaches[J]. J Am Coll Surg, 2015, 220(1): 18-27. 

[22] CAO F, LI J, LI A, et al. Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: a systemic review and Meta-analysis[J]. BMC Surg, 2017, 17(1): 67. 

[23] WANG M, PENG B, LIU J, et al. Practice patterns and perioperative outcomes of laparoscopic pancreaticoduodenectomy in china: a retrospective multicenter analysis of 1029 patients[J]. Ann Surg, 2021, 273(1): 145-153. 

[24] Nagakawa Y, Nakamura Y, Honda G, et al. Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci, 2018, 25(11): 498-507. 

[25] WANG M, MENG L, CAI Y, et al. Learning curve for laparoscopic pancreaticoduodenectomy: a CUSUM analysis[J]. J Gastrointest Surg, 2016, 20(5): 924-935. 

[26] van Hilst J, De Rooij T, Bosscha K, et al. Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial[J]. Lancet Gastroenterol Hepatol, 2019, 4(3): 199- 207. 

[27] ZHOU J, XIONG L, MIAO X, et al. Outcome of robotassisted pancreaticoduodenectomy during initial learning curve versus laparotomy[J]. Sci Rep, 2020, 10(1): 9621. 

[28] Chan K S, Wang Z K, Syn N, et al. Learning curve of laparoscopic and robotic pancreas resections: a systematic review[J]. Surgery, 2021, 170(1): 194-206. 

[29] SHEN Z, WU X, CHEN G, et al. Laparoscopic pancreatoduodenectomy for pancreatic cancer using insitu no-touch isolation technique[J]. J Vis Exp, 2022. DOI: 10.3791/63450. 

[30] JIANG C Y, LIANG Y, WANG H W, et al. Management of the uncinate process via the artery first approach in laparoscopic pancreatoduodenectomy[J]. J Hepatobiliary Pancreat Sci, 2019, 26(9): 410-415. 

[31] van Ramshorst T M E, Edwin B, Han H S, et al. Learning curves in laparoscopic distal pancreatectomy: a different experience for each generation[J]. Int J Surg, 2023, 109(6): 1648-1655. 

[32] Lof S, Vissers F L, Klompmaker S, et al. Risk of conversion to open surgery during robotic and laparoscopic pancreatoduodenectomy and effect on outcomes: international propensity score-matched comparison study[J]. Br J Surg, 2021, 108(1): 80-87.

[33] Lof S, Moekotte A L, Al-Sarireh B, et al. Multicentre observational cohort study of implementation and outcomes of laparoscopic distal pancreatectomy[J]. Br J Surg, 2019, 106(12): 1657-1665. 

[34] Springfeld C, Ferrone C R, Katz M H G, et al. Neoadjuvant therapy for pancreatic cancer[J]. Nat Rev Clin Oncol, 2023, 20(5): 318-337. 

[35] Nassour I, Tohme S, Hoehn R, et al. Safety and oncologic efficacy of robotic compared to open pancreaticoduodenectomy after neoadjuvant chemotherapy for pancreatic cancer[J]. Surg Endosc, 2021, 35(5): 2248-2254. 

[36] Croome K P , Farnell M B , Que F G , et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches[J]. J Gastrointest Surg, 2015, 19(1): 189-194. 

[37] CAI Y , GAO P , L I Y , e t al. Laparoscopic pancreaticoduo-denectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach[J]. Surg Endosc, 2018, 32(10): 4209- 4215. 

[38] OUYANG G, ZHONG X, CAI Z, et al. The shortand long-term outcomes of laparoscopic pancreaticoduodenectomy combining with different type of mesentericoportal vein resection and reconstruction for pancreatic head adenocarcinoma: a Chinese multicenter retrospective cohort study[J]. Surg Endosc, 2023, 37(6): 4381-4395.