摘要随着精准医学和数字医疗的迅速发展，胃肠道恶性肿瘤的诊疗模式正从经验医学向数据驱动医学转变。人工智能（AI）依靠其在图像识别、深度学习及多模态数据分析方面的卓越能力，已全面渗透到胃肠外科的筛查、诊断、治疗及康复等环节。本文系统综述了AI在胃肠外科围手术期全流程中的应用现状：在术前阶段，AI赋能的内镜系统与影像组学显著提高了早期癌的检出率与临床分期的准确性；在术中阶段，增强现实导航与智能机器人系统相互结合，促使手术向更精准、更微创的方向不断发展；在术后阶段，AI赋能下的病理学与多组学融合模型为预后评估与辅助治疗决策提供了量化依据；在围手术期管理方面，智能化认知行为疗法与重症监护预警系统使患者的身心康复体验得到了优化。文章最后深入剖析了AI临床转化所面临的数据孤岛、算法黑箱及伦理监管等诸多挑战，并且对联邦学习与大语言模型在未来的应用前景进行了展望。

abstractsThe shift from the traditional empirical approach to a more data-driven method in the diagnosis and treatment of GI cancers is significant due to advancements in overall precision medicine and digital healthcare. Artificial intelligence(AI),the driving force behind the technological revolution,is increasingly being used in screening,diagnosis,treatment,and rehabilitation in gastrointestinal surgery with its potential to use image recognition,develop a deep learning model and analyse multimodal data. This study systematically reviews how AI is currently being applied across the whole perioperative pathway in GI surgery. During pre-operation procedures,the use of AI assisted endoscopic systems and super-resolution radiomics improved early cancer detection rates and clinical stage predictions. During intraoperative procedures,augmented reality navigation,intelligent robotic systems,and the ‘ultra-minimally invasive’ concept have advanced surgical innovations towards improved precision and reduced invasiveness. After surgery,computational pathology and multi-omics fusion models can be used to assess prognosis and make adjuvant therapy decisions. The physical and psychological rehabilitation experience of patients undergoing perioperative management is optimized with the aid of smart cognitive behavioural therapy and intensive care warning systems. The challenges limiting the clinical translation of artificial intelligence,such as data silos,algorithmic opacity,and ethical regulations,are discussed in detail at the end. After this,possible future applications of federated learning and large language models are envisioned.