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- W2895500675 abstract "Introduction: Dissection of the superior mesenteric artery (SMA) is one of the most important procedure in pancreaticoduodenectomy (PD) for pancreatic cancer. In cases of pancreatic head cancer, surgery often results in noncurative resection, which is frequently related to inadequate clearance of the mesopancreas. Since 2015, we have used the left posterior approach (LPA) for superior mesenteric vascular dissection with total mesopancreas excision, in which the SMA and superior mesenteric vein are dissected first in a clockwise fashion. Methods: A consecutive 45 patients who underwent PD for pancreatic head cancer at our institution between 2012 and 2017 were retrospectively enrolled. 22 patients underwent a LPA between 2015 and 2017 and were compared to 23 patients treated with a conventional approach (CA) between 2012 and 2014. Intraoperative outcomes, postoperative outcomes and pathological findings were evaluated. Results: The mean operative time did not differ between two groups. The mean blood loss in the LPA group was significantly less than that in CA group (p < 0.05). The incidence rate of severe postoperative complications (Grade 3/4 according to Clavien-Dindo classification) did not differ between the groups. No surgery-related deaths occurred in either group. As for pathological residual cancer status, number of positive dissected peripancreatic tissue margin cases was 4/23 in CA group and 1/22 in LPA group. Conclusion: Pancreaticoduodenectomy with left posterior approach may contribute to decreasing total blood loss and improvement of curative resection rate without increasing postoperative complications." @default.
- W2895500675 created "2018-10-12" @default.
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- W2895500675 date "2018-09-01" @default.
- W2895500675 modified "2023-10-16" @default.
- W2895500675 title "Left posterior approach to the superior mesenteric artery in pancreaticoduodenectomy for pancreatic head carcinoma" @default.
- W2895500675 doi "https://doi.org/10.1016/j.hpb.2018.06.2284" @default.
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