手术治疗是胰腺癌最主要的治疗手段，手术切缘阳性、淋巴结转移、周围神经侵犯被认为是导致胰腺癌患者术后局部复发的主要因素。胰腺系膜和胰腺全系膜切除概念的提出，很好地定义了胰头癌手术的切除范围，能提高R0切除率，降低局部复发率。该理念着重于术后最易导致肿瘤残留和局部复发部位的处理。尽管胰腺系膜的概念和胰腺全系膜切除的方法、范围以及效果等存在争议，但作为一种新的手术理念和方法，胰腺全系膜切除值得推荐，效果有待进一步探索和研究。

Surgery is the main treatment for pancreatic cancer. Positive surgical margin, lymph node metastasis and peripheral nerve invasion are considered as the main risk factors of postoperative local recurrence in patients with pancreatic cancer. The introduction of the concepts of mesopancreas excision and total mesopancreas excision well defines the resection range of pancreatic head cancer, which can improve R0 resection rate and reduce local recurrence rate. This concept focuses on the treatment of the sites with the highest risk of tumor residue and local recurrence after surgery. Although the concept of mesopancreas and the method, range and efficacy of total mesopancreas excision remain controversial, as a novel surgical concept and method, total mesopancreas excision should be recommended, whereas the efficacy remains to be validated.