临床外科杂志 ›› 2026, Vol. 34 ›› Issue (7): 737-740.doi: 10.3969/j.issn.1005-6483.20260567

• 专家笔谈 • 上一篇    下一篇

自体小肠移植在局部进展期胰腺癌根治性切除术中的应用体会及展望

杨冲,游欣雨,张宇   

  1. 610072 四川成都,电子科技大学附属医院,四川省人民医院肝胆胰外科
  • 收稿日期:2026-06-30 出版日期:2026-07-20 发布日期:2026-07-20
  • 通讯作者: 张宇,Email:zhangyuqg@med.uestc.edu.cn
  • 作者简介:张宇,Email:zhangyuqg@med.uestc.edu.cn
  • 基金资助:
    国家自然科学基金资助项目(82541034);四川省干部保健科研项目(川干研2024-214);四川省成都市卫健委课题(2024202)

Application experience and future perspectives of intestinal autotransplantation in radical resection for locally advanced pancreatic cancer

YANG Chong, YOU Xinyu, ZHANG Yu   

  1. Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu 610072, China
  • Received:2026-06-30 Online:2026-07-20 Published:2026-07-20

摘要: 自体小肠移植(intestinal autotransplantation,IATx)为局部进展期胰腺癌(locally advanced pancreatic cancer,LAPC)合并肠系膜根部复杂血管侵犯病人实现根治性切除提供了新的外科策略。随着新辅助治疗、器官保护、血管重建及低温灌注等技术的发展,IATx逐渐突破传统不可切除的技术瓶颈,为提高R0切除率及改善病人远期生存创造了条件。本文结合国内外最新研究进展及我们团队临床经验,系统总结IATx在LAPC中的适应证筛选、新辅助治疗后的病人选择、个体化术式设计以及“在体冷灌注”等改良技术的应用特点,并分析其在损伤控制、器官功能保护及围手术期管理中的优势。对IATx目前面临的病人筛选、围手术期风险控制、长期疗效评价及未来发展方向进行了讨论。随着精准外科理念、多学科诊疗模式及综合治疗策略不断完善,IATx及其改良术式有望进一步拓展LAPC及其他肠系膜根部复杂肿瘤的根治性切除适应证,为病人带来更好的长期预后。

关键词: 自体小肠移植, 胰腺癌, 局部进展期, 根治切除

Abstract: Intestinal autotransplantation (IATx) has emerged as a novel surgical strategy to achieve curative resection in patients with locally advanced pancreatic cancer (LAPC) involving complex vascular invasion of the mesenteric root.With advances in neoadjuvant therapy, organ-preserving techniques, vascular reconstruction, and hypothermic perfusion, IATx has gradually overcome the technical barriers that traditionally rendered these tumors unresectable, thereby improving the likelihood of R0 resection and enhancing long-term survival outcomes.Based on the latest domestic and international evidence, together with our institutional experience, this review systematically summarizes the indications for IATx in LAPC, patient selection following neoadjuvant therapy, individualized surgical planning, and the application of modified techniques such as in situ cold perfusion.In addition, the advantages of IATx in damage control, organ function preservation, and perioperative management are discussed.Current challenges, including optimal patient selection, perioperative risk management, long-term outcome evaluation, and future directions, are also addressed.As precision surgery, multidisciplinary team (MDT) management, and multimodal treatment strategies continue to evolve, IATx and its modified approaches are expected to further expand the indications for curative resection in patients with LAPC and other complex tumors involving the mesenteric root, ultimately leading to improved long-term prognosis.

Key words: intestinal autotransplantation, pancreatic cancer, locally advanced, radical resection

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