从整体性视角思考胆胰相关疾病的规范化诊治与研究OA
Standardized diagnosis,treatment,and research of biliopancreatic diseases from an integrated perspective
胆胰相关疾病具有共同的胚胎起源、毗邻的解剖关系、相互关联的生理功能及相似的疾病谱,其在发病机制、临床表现、诊断与治疗等方面亦存在密切联系.因此,从整体性视角认识胆胰相关疾病,对于明确病因、规范诊疗及优化治疗策略具有重要意义.当前临床实践中仍存在专科分割、整体性思维不足、过度依赖影像学而忽视病理依据,以及对Oddi括约肌功能及其保护认识不足等问题.针对不明原因的胆胰管扩张、胰腺段胆总管囊肿、胆管末端狭窄和Oddi括约肌功能障碍等诊疗难点,应加强胆胰相关疾病的整体化评估,重视多学科诊疗和系统化随访在诊疗决策中的作用,避免漏诊漏治、误诊误治及过度治疗.同时,应从整体性视角开展胆胰管汇合方式、胆胰肿瘤发病机制及精准诊疗、Oddi括约肌功能等方面的基础与临床研究,以进一步提高胆胰相关疾病诊疗的科学性、规范性和有效性.
Biliopancreatic diseases share common embryonic origins,close anatomical relationships,interconnected physiological functions,and similar disease spectra,with substantial similarities in their pathogenesis,clinical manifestations,diagnosis,and treatment.Therefore,an integrated perspective is important for identifying the underlying causes,standardizing clinical management,and optimizing therapeutic strategies for biliopancreatic diseases.However,current clinical practice is still characterized by excessive subspecialization and fragmentation,insufficient holistic thinking,overreliance on imaging findings with inadequate attention to pathological evidence,and insufficient recognition of the function and preservation of the sphincter of Oddi.For challenging conditions,including unexplained biliopancreatic duct dilatation,pancreatic-segment choledochal cysts,distal bile duct strictures,and sphincter of Oddi dysfunction,comprehensive assessment of the biliopancreatic system should be emphasized.Multidisciplinary team management and systematic follow-up should be incorporated into clinical decision-making to reduce missed diagnoses,inappropriate treatment,and overtreatment.Meanwhile,research from an integrated perspective should focus on the patterns of biliopancreatic duct confluence,the pathogenesis and precision management of biliopancreatic malignancies,and the basic and clinical characteristics of sphincter of Oddi function,thereby further improving the scientific,standardized,and effective management of biliopancreatic diseases.
王伟;王坚
上海交通大学医学院附属第六人民医院 肝胆胰外科,上海 200233上海交通大学医学院附属第六人民医院 肝胆胰外科,上海 200233
医药卫生
胆管胰腺管胆总管囊肿奥狄括约肌功能障碍整体化诊疗
Bile DuctsPancreatic DuctsCholedochal CystSphincter of Oddi DysfunctionIntegrated Management
《中国普通外科杂志》 2026 (8)
1520-1528,9
国家自然科学基金资助项目(82273411).
评论