患者男45岁因皮肤巩膜黄染1周入院患者入院前1周无明显诱因出现皮肤巩膜黄染伴有皮肤轻度瘙痒无明显腹痛腹胀无畏寒发热院外超声及CT均提示胰头部占位考虑胰腺癌入院后进一步磁共振检查提示胰头直径约2cm大小实性占位伴胆总管扩张、梗阻与周围血管关系不大实验室检查提示胆红素稍高CA199明显升高。入院诊断为胰腺癌考虑为可切除性。外科手术是目前治疗胰腺肿瘤最常用和最主要的手段但行传统开腹以胰十二指肠切除术还是

PICO问题构建： P（患者）：45岁男性患者，确诊为可切除性胰腺癌 I（干预）：传统开腹胰十二指肠切除术 C（对照）：腹腔镜胰十二指肠切除术 O（结果）：手术效果和患者预后

检索词及检索策略：

1. "Pancreatic neoplasms"[Mesh] AND "Pancreaticoduodenectomy"[Mesh]
2. "Pancreatic Neoplasms/surgery"[Mesh] AND "Laparoscopy"[Mesh]
3. "Pancreatic Neoplasms"[Mesh] AND "Pancreaticoduodenectomy"[Mesh] AND "Laparoscopy"[Mesh]
4. "Pancreatic Neoplasms/surgery"[Mesh] AND "Pancreaticoduodenectomy/methods"[Mesh]

循证医学检索数据库：

1. PubMed
2. Embase
3. Cochrane Library
4. Web of Science

检索结果：

1. 文章题目：Comparison of laparoscopy-assisted and open pancreaticoduodenectomy for periampullary tumors: a systematic review and meta-analysis. 摘要：This meta-analysis suggests that laparoscopy-assisted pancreaticoduodenectomy (LAPD) is associated with less blood loss, shorter hospital stay, and similar oncologic outcomes compared with open pancreaticoduodenectomy (OPD) for periampullary tumors. 出处：Surgical Endoscopy 级别：Systematic review and meta-analysis

2. 文章题目：Laparoscopic Pancreaticoduodenectomy: A Systematic Review and Meta-analysis. 摘要：Laparoscopic pancreaticoduodenectomy (LPD) is a feasible and safe procedure, which is associated with reduced blood loss, earlier recovery, and similar oncologic outcomes compared with open pancreaticoduodenectomy (OPD). 出处：Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 级别：Systematic review and meta-analysis

根据证据结果和疾病相关指南，给家属提出治疗建议： 根据上述两篇较高级别的证据，传统开腹胰十二指肠切除术和腹腔镜胰十二指肠切除术在手术效果方面相似，但腹腔镜手术具有更小的术中出血量和更短的住院时间，并且术后恢复更快。因此，建议患者选择腹腔镜胰十二指肠切除术作为治疗方法。但具体手术方式的选择还需结合患者的具体情况和医生的专业意见做出最终决定