探讨术前经内镜植入胆胰管支架在胰腺头颈部肿瘤局部切除中的应用价值。

采用回顾性描述性研究方法。收集2019年1月至2022年12月收治的26例胰腺头颈部肿瘤局部切除患者的临床资料；男10例，女16例；中位年龄54（17~72）岁。患者均在术前经内镜植入支架。观察指标：（1）手术情况。（2）术后情况。计量资料以绝对数表示。

（1）手术情况：所有患者均在术前行内镜逆行胰胆管造影（ERCP）放置支架，其中20例在手术当天放置支架。所有患者均放置了胰管支架，有21例患者同时放置了胆管支架。2例合并胰头、胰尾多发病变，行胰尾切除+胰头局部切除，其余患者均为单一区域病变行胰腺肿瘤局部切除。11例患者肿瘤局部切除的同时，创面加做了胰肠Roux-en-Y吻合。（2）术后情况：26例患者均无手术相关死亡，平均住院20.8 d。13例发生B级胰瘘，7例发生生化瘘，无C级瘘发生。3例发生胃排空障碍，其中C级2例，A级1例。4例发生术后出血，A级1例，B级3例。1例发生胆瘘。5例合并腹腔包裹性积液。

术前经内镜胆胰管支架植入应用于胰腺肿瘤局部切除术，扩大了胰腺肿瘤局部切除术的适应证，对于保护胆胰管，降低手术难度，提高手术成功率，加快患者康复减少术后胰瘘、胆瘘发生具有一定帮助，是安全可行的。

To investigate the application value of preoperative endoscopic biliary and pancreatic stenting in local resection of pancreatic head and neck tumors.

A retrospective descriptive study was conducted. Clinical data of 26 patients who underwent local resection of pancreatic head and neck tumors from January 2019 to December 2022 were collected, including 10 males and 16 females, with a median age of 54 years (range, 17~72 years). All patients received preoperative endoscopic stent placement. Observation indicators: (1) perioperative conditions; (2) postoperative conditions. Measurement data were expressed as absolute numbers.

(1) Perioperative conditions: All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for stent placement before surgery, among whom 20 received stent placement on the day of surgery. A pancreatic duct stent was placed in all patients, and a biliary stent was additionally placed in 21 patients. Two patients with multiple lesions in the pancreatic head and tail underwent distal pancreatectomy plus local resection of the pancreatic head, while the others with single lesions underwent local resection of pancreatic tumors only. Eleven patients underwent Roux-en-Y pancreaticojejunostomy during local tumor resection. (2) Postoperative conditions: No surgery-related death occurred in the 26 patients, with a mean hospital stay of 20.8 days. Grade B pancreatic fistula occurred in 13 patients, biochemical fistula in 7, and no grade C fistula was observed. Delayed gastric emptying occurred in 3 patients (grade C in 2, grade A in 1). Postoperative hemorrhage occurred in 4 patients (grade A in 1, grade B in 3). Biliary fistula occurred in 1 patient. Five patients had intra-abdominal encapsulated effusion.

Preoperative endoscopic biliary and pancreatic stenting is safe and feasible in local resection of pancreatic tumors. It extends the indications of local resection, helps protect the biliary and pancreatic ducts, reduces surgical difficulty, improves surgical success rate, accelerates postoperative recovery, and reduces the incidence of postoperative pancreatic fistula and biliary fistula.