中华外科杂志最新文献

{"title":"[Total hip arthroplasty for Crowe type Ⅳ developmental dysplasia of the hip acetabular localization and reconstruction techniques].","authors":"Y J Huang, M F Li, G Wang, Y X Gui, H Li, H B Xie, J F Yi, Z B Niu, X P Kong, W Chai","doi":"10.3760/cma.j.cn112139-20260317-00110","DOIUrl":"10.3760/cma.j.cn112139-20260317-00110","url":null,"abstract":"<p><p><b>Objective:</b> To introduce an acetabular reconstruction technique for total hip arthroplasty (THA) in patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH), and report its mid-term clinical outcomes. <b>Methods:</b> This is a retrospective case series study. Clinical data of 231 patients (310 hips) with Crowe type Ⅳ DDH who consecutively underwent THA via the posterolateral approach at the First and the Fourth Medical Centers of the Chinese People's Liberation Army General Hospital from August 2018 to April 2024 were retrospectively analyzed, and all patients had complete surgical and follow-up records. There were 17 males and 214 females, with an age of (43.9±9.8) years (range:18 to 60 years) and a body mass index of (24.0±3.1) kg/m² (range:17 to 30 kg/m²). Intraoperatively, the \"ABCDE\" method for true acetabulum identification (A: acetabular capsule; B: bone ridge; C: ligamentum capitis femoris; D: detect with index finger; E: exploration via ligamentum transversum) was adopted to precisely locate the true acetabulum, together with standardized operative essentials for acetabular reaming and acetabular cup implantation. All patients were followed up for no less than 1 year postoperatively. Preoperative and postoperative Harris Hip Score (HHS) and leg length discrepancy were measured and recorded, and perioperative complications were documented. The paired-sample <i>t</i>-test was used to compare preoperative and postoperative indicators. <b>Results:</b> All patients successfully received the surgery and completed follow-up. Among all hips, 223 were treated with robotic or navigation-assisted THA, and 87 with conventional THA. The operative time was (131.7±27.5) min (range:91 to 170 min). Intraoperatively, ceramic-on-ceramic bearing surfaces were used in 195 hips, ceramic-on-highly cross-linked polyethylene in 114 hips, and metal-on-polyethylene in 1 hip. Modular femoral stems were implanted in all hips, and subtrochanteric osteotomy was performed in 205 hips. The postoperative hospital stay was (5.2±2.8) d (range:3 to 9 d). The follow-up period was (28.8±14.2) months (range:12 to 46 months). Acetabulum-related complications occurred in 6 hips, including 3 cases of hip dislocation and 3 cases of acetabular fracture; secondary open reduction surgery was performed in 3 hips due to postoperative dislocation. The HHS significantly increased from preoperative (60.0±14.1) points (range:40 to 74 points) to postoperative (95.9±3.1) points (range:88 to 99 points) (<i>t</i>=32.450, <i>P</i><0.01). The absolute value of postoperative leg length discrepancy was (6.5±3.3) mm (range:0 to 18 mm), which was significantly lower than the preoperative value of (17.6±11.2) mm (range:1 to 50 mm) (<i>t</i>=9.152, <i>P</i><0.01). <b>Conclusion:</b> The true acetabulum localization and acetabular reconstruction technique adopted in this study can accurately identify the native acetabulum, improve the stability of the acetabular component, and si","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 9","pages":"961-969"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Computational medicine empowers multi-dimensional diagnosis and treatment of pancreatic cancer].","authors":"B W Hu, B Y Shen","doi":"10.3760/cma.j.cn112139-20260427-00171","DOIUrl":"10.3760/cma.j.cn112139-20260427-00171","url":null,"abstract":"<p><p>Due to its high genomic heterogeneity and dense desmoplastic microenvironment, traditional diagnosis and treatment for pancreatic ductal adenocarcinoma (PDAC) have limited effects. The management of PDAC is further complicated by persistent clinical bottlenecks,including inadequate accuracy in image-based staging, high surgical complexity,and limited systemic treatment options prone to drug resistance. These problems urgently require breakthroughs to enhance PDAC treatment outcomes and long-term survival. In recent years, computational medicine,which integrates artificial intelligence, machine learning, high-throughput multi-omics, and mathematical modeling, has sought to overcome these formidable challenges. It is currently driving a paradigm shift in the comprehensive diagnosis and treatment of PDAC,moving from a population-based standardized clinical protocols toward a novel framework characterized by digitalization,intelligence,multi-dimensionality,and precision. This article summarizes the cutting-edge advancements of computational medicine in the multi-dimensional diagnosis and treatment of PDAC,focusing on three key areas: radiological evaluation,surgical assistance,and pharmacotherapy. Although numerous challenges remain, the exponential growth in computational efficiency,which is coupled with the continuous maturation of explainable artificial intelligence,positions computational medicine to play a pivotal role in the global effort to conquer PDAC.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"861-866"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Medical transformation in an aging society: prioritizing geriatric surgery development in China].","authors":"Y P Zhao","doi":"10.3760/cma.j.cn112139-20260529-00227","DOIUrl":"10.3760/cma.j.cn112139-20260529-00227","url":null,"abstract":"<p><p>Population aging is one of the most defining societal transformations of the 21st century. Transcending a mere demographic change, it exerts a profound influence on national development strategies while directly impacting the health and well-being of families. Geriatric surgery, as a frontline field addressing these challenges, has emerged as a cornerstone of surgical care. Herein, we delineate the current state and prevailing constraints of geriatric surgery in China, and propose strategic pathways for its future evolution; all of which aims to provide actionable guidance for the implementation of the \"Healthy China 2030\" Planning Outline and to foster the high-quality advancement of geriatric surgical care nationwide.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"837-840"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical rescue for severe acute pancreatitis complicated by infected pancreatic necrosis and sepsis: a clinical practice analysis].","authors":"J W Wu, J S Hu, R Bai, Q Y Li, R Kong, H Chen, Y W Wang, G Q Li, C Y Li, Y C Han, X L Wang, B Sun","doi":"10.3760/cma.j.cn112139-20260127-00039","DOIUrl":"10.3760/cma.j.cn112139-20260127-00039","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the therapeutic efficacy of surgical rescue (SR) in patients with severe acute pancreatitis (SAP) complicated by infected pancreatic necrosis (IPN) and sepsis,and to identify the risk factors associated with SR failure. <b>Methods:</b> Clinical data were retrospectively collected from 130 patients with SAP complicated by IPN who developed sepsis and were admitted to the First Affiliated Hospital of Harbin Medical University between January 2019 and October 2025. The cohort included 86 males and 44 females,with an age(<i>M</i>(IQR)) of 47(21) years (range:22 to 74 years). Patients were divided into an SR group (<i>n</i>=86) and a non-SR group (<i>n</i>=44) based on whether SR was performed. Significant differences were observed between the two groups in age,Balthazar-CTSI score,and creatinine and urea nitrogen levels at the onset of sepsis (all <i>P</i><0.05). After propensity score matching (PSM) with a 1∶1 nearest-neighbor method and a caliper value of 0.2 to balance baseline characteristics,76 patients were included (38 in each group). Patients were also divided into an SR success group (<i>n</i>=52) and an SR failure group (<i>n</i>=34). Univariate analysis was performed using independent sample <i>t</i>-test,Mann-Whitney <i>U</i> test,chi-square test,or Fisher's exact test as appropriate. Variables with <i>P</i><0.05 in univariate analysis were included in a multivariate logistic regression model. The predictive value of the model for SR failure was assessed using receiver operating characteristic (ROC) curve analysis. <b>Results:</b> Multivariate logistic regression analysis identified SR as an independent protective factor for survival (<i>OR</i>=0.184,95%<i>CI:</i> 0.063 to 0.537,<i>P</i><0.05). Kaplan-Meier survival curves showed that the 28-d cumulative survival rate was higher in the SR group than that in the non-SR group (<i>χ²</i>=14.950,<i>P</i><0.05). Multivariate Logistic analysis identified age (<i>OR</i>=1.188, 95%<i>CI:</i> 1.068 to 1.322),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score (<i>OR</i>=1.303,95%<i>CI</i>: 1.043 to 1.628),sequential organ failure assessment (SOFA) score at the onset of sepsis (<i>OR</i>=1.840,95%<i>CI:</i> 1.205 to 2.811), and timing of first SR (<i>OR</i>=3.004, 95%<i>CI:</i> 1.208 to 7.469) as independent risk factors for SR failure (all <i>P</i><0.05). The area under the ROC curve was 0.950 (95%<i>CI</i>: 0.903 to 0.997). <b>Conclusions:</b> SR can prolong survival time in SAP patients with IPN who develop sepsis. Age, higher APACHE Ⅱ score,higher SOFA score at initial sepsis diagnosis,and delayed time to first SR are independent prognostic factors for SR failure.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"912-920"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Repositioning pancreatic surgery and pancreatic surgeons in the era of multidisciplinary treatment for pancreatic cancer].","authors":"N Pu, L Liu","doi":"10.3760/cma.j.cn112139-20260316-00108","DOIUrl":"10.3760/cma.j.cn112139-20260316-00108","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is characterized by early micrometastatic spread, highly aggressive tumor biology, and a high risk of recurrence. As a result, the traditional treatment paradigm centered on surgery alone has been insufficient to achieve sustained improvements in overall survival. Over the past five years, perioperative systemic treatment strategies have evolved substantially, with growing evidence supporting neoadjuvant and conversion therapies, more refined use of locally intensified modalities such as radiotherapy and ablation, and the gradual incorporation of biomarkers-including CA19-9, ctDNA, and molecular residual disease-into clinical research and practice. Together, these advances have accelerated a shift in PDAC management from a \"resection-centered\" model toward a comprehensive treatment paradigm focused on benefit across the entire disease course. Within this new paradigm，the value of pancreatic surgery has not diminished；rather，it has expanded from \"achieving resection\" to \"designing the full treatment pathway and making key decisions at critical junctures\".Its core responsibilities now include benefit-based stratification according to anatomy, tumor biology, and host condition; perioperative sequence management and ensuring treatment completion rates; dual quality control of oncologic adequacy and perioperative safety; recurrence risk stratification and integration of reintervention strategies; and the development of disease-specific center models driven by clinical research and real-world data. Accordingly, the role of the pancreatic surgeon must evolve from that of a \"technical resectionist\" to that of an \"MDT pathway leader，perioperative treatment coordinator，local therapy integrator，and quality management steward\". Drawing on recent guideline updates and pivotal clinical studies, this article systematically discusses the repositioning of pancreatic surgery and pancreatic surgeons in the era of multidisciplinary, integrated treatment.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"867-873"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Arterial variations and management strategies in pancreatic surgery].","authors":"L Y Liu, Z Y Fan, R X Wang, H X Zhan","doi":"10.3760/cma.j.cn112139-20260109-00016","DOIUrl":"10.3760/cma.j.cn112139-20260109-00016","url":null,"abstract":"<p><p>The pancreas is local in the retroperitoneal space,in close proximity to critical blood vessels such as celiac trunk, superior mesenteric artery, hepatic artery, splenic artery, and gastroduodenal artery. The high incidence of anatomical variations in these arteries significantly increases the complexity of pancreatic surgery. Such variations-particularly aberrant origins of the right hepatic artery, dorsal pancreatic artery, and gastroduodenal artery, as well as an anomalous course of the splenic artery,are strongly associated with complications such as intraoperative hemorrhage, positive resection margins, and hepatic ischemia. Currently, the clinical application of high-resolution computed tomography angiography, three-dimensional reconstruction, three-dimensional printing, and artificial intelligence-assisted imaging analysis has facilitated highly precise preoperative evaluation of these vascular networks. This review systematically summarizes the common arterial variations encountered during pancreatic surgery. By specifically analyzing the anatomical anomalies of the hepatic, dorsal pancreatic, inferior pancreaticoduodenal, gastroduodenal, and splenic arteries, corresponding surgical strategies are proposed to provide a practical reference for the safe and precise execution of pancreatic procedures.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"874-881"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Safety and efficacy of bovine pericardial patch wrapping of the hepatic artery for preventing delayed postpancreatectomy hemorrhage after laparoscopic pancreaticoduodenectomy].","authors":"A Z Hu, J Wang, H Q Ma, L Liu, Y S Du, H D Tang, W X Zhao","doi":"10.3760/cma.j.cn112139-20260223-00075","DOIUrl":"10.3760/cma.j.cn112139-20260223-00075","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety and efficacy of wrapping the skeletonized hepatic artery and gastroduodenal artery (GDA) stump with a bovine pericardial patch during laparoscopic pancreaticoduodenectomy (LPD) for the prevention of delayed postpancreatectomy hemorrhage. <b>Methods:</b> This retrospective cohort study included 217 patients who underwent LPD at the Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, between June 2020 and February 2025. There were 135 male and 82 female patients, with an age of (63±13) years (range: 13 to 90 years). According to whether a bovine pericardial patch was used intraoperatively to wrap the hepatic artery and GDA stump, the patients were divided into a patch group (<i>n</i>=109) and a control group (<i>n</i>=108). Perioperative outcomes, postoperative complications, and follow-up results were compared between the two groups using the independent samples <i>t</i>-test, Mann-Whitney <i>U</i> test, repeated measures ANOVA, Pearson <i>χ</i>² test, or Fisher's exact test. Univariate and multivariate Logistic regression analyses were performed to identify factors associated with delayed hemorrhage. <b>Results:</b> There were no significant between-group differences in postoperative complications(all <i>P</i>>0.05), including clinically relevant postoperative pancreatic fistula (19.3%(21/109) <i>vs.</i> 22.2%(24/108)), bile leak (5.5%(6/109) <i>vs.</i> 0.9%(1/108)), delayed gastric emptying (1.8%(2/109) <i>vs.</i> 0), and intra-abdominal infection (3.7%(4/109) <i>vs.</i> 5.6%(6/108)). Delayed PPH occurred in 4 patients(3.7%) in the patch group and 12 patients (11.1%) in the control group (<i>P</i>=0.041). GDA stump bleeding occurred in 1 patient(0.9%) in the patch group and 8 patients(7.4%) in the control group (<i>P</i>=0.019). Multivariate logistic regression analysis identified patch wrapping as an independent protective factor against delayed postpancreatectomy hemorrhage (PPH) (<i>OR</i>=0.206, 95%<i>CI</i>:0.055 to 0.768, <i>P</i>=0.019), whereas clinically relevant postoperative pancreatic fistula was an independent risk factor (<i>OR</i>=16.623, 95%<i>CI</i>:4.759 to 48.061, <i>P</i><0.01). <b>Conclusion:</b> Wrapping the hepatic artery and GDA stump with a bovine pericardial patch during LPD can significantly reduce delayed PPH, particularly GDA stump bleeding, without increasing major perioperative complications, and appears to be a safe and effective preventive strategy.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"893-903"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of the \"2+3\" pancreaticojejunostomy in 110 cases of pancreaticoduodenectomy].","authors":"S L Guo, S H Chen, H Liu, L Wang, J W Xu","doi":"10.3760/cma.j.cn112139-20251116-00534","DOIUrl":"10.3760/cma.j.cn112139-20251116-00534","url":null,"abstract":"<p><p><b>Objective:</b> To report the outcomes and evaluate the safety of the \"2+3\"pancreaticojejunostomy in pancreaticoduodenectomy. <b>Methods:</b> This retrospective case series analyzed clinical data from 110 consecutive pancreaticoduodenectomy patients who underwent \"2+3\" pancreaticojejunostomy, performed by a single surgeon at Qilu Hospital of Shandong University between December 2022 and July 2025. The cohort comprised 61 males and 49 females, with an age of (60.9±10.9) years (range: 21 to 83 years). Four patients (3.6%) received neoadjuvant therapy preoperatively. The technique features a modified duct-to-mucosa anastomosis: the \"2\" denotes a double-layer continuous suture of the anterior and posterior pancreatic parenchyma to the jejunum using 4-0 non-absorbable suture, with the posterior line incorporating the dorsal pancreatic duct wall and the jejunotomy; the \"3\" signifies three interrupted duct-to-mucosa sutures placed at the 6, 12, and 3 o'clock positions using 4-0 absorbable suture. Clinical and pathological data were compared using Student's <i>t</i>-test, Mann-Whitney <i>U</i> test, <i>χ²</i> test, or Fisher's exact test. <b>Results:</b> The overall postoperative complication rate was 20.0% (22/110), with a 9.1% (10/110) incidence of clinically relevant postoperative pancreatic fistula (CR-POPF). No instances of grade C postoperative pancreatic fistula, reoperations, or perioperative deaths occurred. The postoperative hospital stay was (13.6±4.0) d (range: 7 to 27 d). The pathological types included pancreatic cancer (<i>n</i>=54, 49.1%), duodenal cancer (<i>n</i>=29, 26.4%), distal cholangiocarcinoma (<i>n</i>=10, 9.1%) and other tumors (<i>n</i>=17,15.5%). Patients were categorized based on surgical approach into laparoscopic pancreaticoduodenectomy (LPD) (<i>n</i>=44) and open pancreaticoduodenectomy (OPD) (<i>n</i>=66) groups. There was no statistically significant difference in the CR-POPF rate between the LPD group and the OPD group (15.9% (7/44) <i>vs.</i> 4.5% (3/66), <i>P</i>=0.086). Based on pancreatic duct diameter, patients were divided into a non-dilated duct group (<i>n</i>=79) and a dilated duct group (<i>n</i>=31). Compared with the dilated duct group(0 (0/31)), the CR-POPF incidence in the non-dilated duct group(12.7% (10/79)) showed no statistically significant difference (<i>P</i>=0.059). There were no statistically significant differences in operative time, intraoperative blood loss, CR-POPF rate, or postoperative hospital stay between patients with soft pancreas (<i>n</i>=68) and hard pancreas (<i>n</i>=42) (all <i>P</i>>0.05). <b>Conclusion:</b> The \"2+3\" pancreaticojejunostomy technique for pancreatic reconstruction during pancreaticoduodenectomy is effective and reliable.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"886-892"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics,prevention and treatment difficulties,and management strategies for severe acute pancreatitis in cold regions].","authors":"G Q Li, B Sun","doi":"10.3760/cma.j.cn112139-20260317-00112","DOIUrl":"10.3760/cma.j.cn112139-20260317-00112","url":null,"abstract":"<p><p>The climate and lifestyle in cold regions make hyperlipidemia the primary etiology of pancreatitis in these areas. The disease exhibits a peak incidence in autumn and winter, with a tendency toward severe presentation, poor prognosis, and high recurrence. Severe acute pancreatitis (SAP) in cold regions is characterized by rapid progression of the early inflammatory response, early onset of organ failure with prominent cardiac and cerebral involvement, a complicated and refractory infection stage, and a long-term predisposition to post-pancreatitis diabetes mellitus. Establishing a regional pancreatic disease diagnosis and treatment center is an important measure to address the challenges in the management of pancreatic diseases in cold regions. Early intensive fluid resuscitation and organ support therapy, appropriate timing and selection of surgical intervention during the infection stage, and enhanced systematic management of post-SAP metabolic complications are key to improving the treatment efficacy of SAP in cold regions. This article aims to provide a theoretical basis for establishing a cold region-adaptive comprehensive prevention and treatment system for SAP.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"856-860"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Consensus on minimally invasive liver resection day surgery(2026)].","authors":"","doi":"10.3760/cma.j.cn112139-20260416-00155","DOIUrl":"10.3760/cma.j.cn112139-20260416-00155","url":null,"abstract":"<p><p>The integration of minimally invasive liver resection (MILR) with enhanced recovery after surgery principles has enabled the feasibility of same-day discharge liver surgery. Based on the latest evidence-based practice from domestic and international experience, this consensus systematically elaborates on admission criteria, perioperative management, and post-discharge follow-up systems for day-case MILR. The admission system emphasizes rigorous institutional and surgeon qualification review, individualized patient selection, and disease-specific surgical assessment. Perioperative management encompasses preoperative one-stop evaluation and prehabilitation, intraoperative refined techniques with multimodal analgesia, and postoperative fast-track recovery pathways. Post-discharge management establishes stratified follow-up and emergency response mechanisms. The quality control system promotes continuous improvement through core indicator monitoring. This consensus aims to provide evidence-based guidance for the standardized implementation of day-case MILR and achieve dual enhancement of healthcare efficiency and patient experience.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 8","pages":"841-849"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}