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中文译文　摘要　胰腺癌是一种少见但致命的疾病。由于肿瘤尚局限时缺乏症状或症状不典型，患者确诊时多已属进展期。高质量影像处理系统已实际用于胰腺肿瘤的检出与手术可行性的判断，ERCP 等术前手段也日益增多地用于补充分期。胰十二指肠切除术是具有潜在并发症风险的复杂手术之一；过去十年间，机器人辅助与腹腔镜微创胰腺切除已在世界范围内成为标准外科实践的一部分。此外，辅助化疗的进展改善了当前临床实践中的长期结局；包括靶向药物在内的系统性保守治疗仍是晚期患者的主要治疗手段。越来越多的研究着眼于调控胰腺肿瘤微环境，以提高免疫治疗策略的疗效。本文考察了术前治疗、新手术策略与个体化全身治疗在胰腺癌中的作用，并总结了确立胰腺癌新辅助与外科治疗方案的随机对照研究。关键词：里程碑；胰腺癌

Abstract Pancreatic cancer is a rare but fatal disease. Patients present advanced disease due to the lack of or typical symptoms when the tumor is still localized. A high-quality image processing system has been in practice to detect the pancreatic tumor and determine the possibility of surgery, and preoperative methods, such as ERCP are increasingly used to complement the staging modality. Pancreaticoduodenectomy is one of the complicated surgeries with potential morbidity. The minimally invasive pancreatic resections, both robot-assisted and laparoscopic, have become a part of standard surgical practice worldwide over the last decade. Moreover, advancements in adjuvant chemotherapy have improved the long-term outcomes in current clinical practice. The systemic conservative treatment, including targeted agents, remains the mainstay of treatment for patients with advanced disease. An increasing number of studies are focused on modulating the pancreatic tumor microenvironment to improve the efficacy of the immunotherapeutic strategies. Herein, the role of preoperative therapy, the novel surgical strategy, and individualized systemic treatment in pancreatic cancer is investigated. Also, the randomized controlled studies that have defined the neoadjuvant and surgical management of pancreatic cancer have been summarized. Keywords: Landmarks, Pancreatic cancer