腹腔镜不保留脾血管的保脾胰体尾切除术（Warshaw 术式）中国专家共识（2026版）

Chinese expert consensus on laparoscopic spleen-preserving distal pancreatectomy with splenic vessel resection（Warshaw procedure）（2026）

摘要

随着腹腔镜技术的进步及保留器官功能理念的深入人心,腹腔镜保脾远端胰腺切除术已在临床广泛应用,该手术方式包括腹腔镜保留脾血管的保脾胰体尾切除术（Kimura 术式）与腹腔镜不保留脾血管的保脾胰体尾切除术（Warshaw 术式）。其中 Kimura 术式技术难度高,容易损伤血管,出血多;而 Warshaw 术式则具有安全、学习曲线短等优点,但 Warshaw 术式目前国内尚缺乏统一的手术规范。为促进该术式的规范化开展,中国研究型医院学会微创外科学专业委员会组织国内专家制定本共识。本共识基于最新的研究成果及临床实践经验,详细阐述了腹腔镜 Warshaw 术式的适应证、禁忌证、手术操作流程及术后管理等主要内容,并提出专家推荐意见,以期为临床医师提供科学、规范的指导。共识的目标人群为接受腹腔镜 Warshaw 术式的患者,使用人群为从事胰腺疾病治疗的各级医疗机构外科医生、护理及相关技术人员。

Abstract

With advancements in laparoscopic technology and the deepened emphasis on organ-preserving strategies, laparo- scopic spleen-preserving distal pancreatectomy（LSPDP）has been widely used in clinical practice.This procedure includes laparoscopic spleen-preserving distal pancreatectomy with splenic vessel preservation（the Kimura procedure）and laparoscopic spleen-preserving distal pancreatectomy without splenic vessel preservation（the Warshaw procedure）.The Kimura procedure is technically challenging, carries a higher risk of vascular injury, and may result in increased bleeding, whereas the Warshaw procedure offers advantages such as safety and a shorter learning curve.However, there is currently no unified surgical standard for the Warshaw procedure in China.To pro- mote the standar-dized implementation of this technique, the Minimally Invasive Surgery Committee of the Chinese Research Hospital Association organized domestic experts to develop this consensus.Based on the latest research findings and clinical practice experience, this consensus e laborates on the main contents of the laparoscopic Warshaw procedure, including indications, contraindications, surgical operation processes, and postoperative management, and proposes expert recommendations, aiming to provide scientific and standardized guidance for clinicians.The target population of this consensus comprises patients undergoing laparoscopic Warshaw procedures.Its in- tended users include surgeons, nursing staff, and related technical personnel engaged in pancreatic disease management across all levels of healthcare institutions.

关键词

远端胰腺切除术 / 保脾手术 / 腹腔镜检查 / 专家共识

Key words

Distal pancreatectomy / Spleen-preservingprocedures / Laparoscopy / Expert consensus