数智赋能胰腺外科：技术创新及临床实践

Digital intelligence empowering pancreatic surgery: technological innovation and clinical practice

摘要:

胰腺外科因其解剖复杂、手术风险高而被视为外科领域的“高地”。近年来，三维重建、荧光导航、增强现实（AR）、混合现实（MR）与人工智能（AI）等数智化技术的引入，为胰腺外科的精准、安全与智能化发展提供了新的解决方案。本文系统梳理了数智化技术在胰腺外科“术前规划-术中导航-术后监测”全流程中的创新应用与临床实践。术前，通过基于深度学习的nnU-Net框架实现胰周血管与胆胰管的高精度三维重建，辅助个体化手术规划；术中，结合吲哚菁绿荧光成像、AR/MR及多模态影像融合技术，实现血管、胆管与肿瘤边界的实时可视化与动态定位，提高解剖识别精度与操作安全性；术后，AI结合可穿戴设备与多模态数据监测，推动并发症风险的智能预测与早期干预。数智化技术的系统性融合正重塑胰腺外科诊疗范式，助力实现从经验驱动到数据驱动、从术者依赖到智能决策的转变。未来，随着算法优化与循证证据积累，数智赋能将持续推动胰腺外科向个体化、精准化、智能化迈进。

Abstract:

Pancreatic surgery remains one of the most challenging fields in general surgery due to its complex anatomy and high risk of complications. In recent years, the integration of digital intelligent technologies-such as three-dimensional (3D) reconstruction, fluorescence navigation, augmented/mixed reality (AR/MR), and artificial intelligence (AI)-has provided new strategies for achieving precision, safety, and intelligence in pancreatic surgery. This review summarizes the innovations and clinical applications of these technologies throughout the full perioperative process, including preoperative planning, intraoperative navigation, and postoperative monitoring. Preoperatively, the deep learning-based nnU-Net framework enables high-precision 3D reconstruction of peripancreatic vessels and pancreaticobiliary ducts for individualized surgical planning. Intraoperatively, multimodal image fusion combining indocyanine green fluorescence imaging with AR/MR navigation allows real-time visualization and spatial localization of key anatomical structures, enhancing surgical accuracy and safety. Postoperatively, AI-driven models integrated with wearable sensors and multimodal data support intelligent risk prediction and early intervention for complications. The systematic application of digital intelligence is reshaping the paradigm of pancreatic surgery, driving the transition from experience-based to data-driven and from surgeon-dependent to intelligent decision-making. With continuous algorithmic refinement and accumulation of clinical evidence, digital empowerment will further advance pancreatic surgery toward personalization, precision, and intelligence.