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Review
. 2014 Sep 15;6(9):344-50.
doi: 10.4251/wjgo.v6.i9.344.

Tricks and tips in pancreatoduodenectomy

Anna Pallisera  1 , Rafael Morales  1 , Jose Manuel Ramia  1
Affiliations
Review

Tricks and tips in pancreatoduodenectomy

Anna Pallisera et al. World J Gastrointest Oncol. .

Abstract

Pancreaticoduodenectomy (PD) is the standard surgical treatment for tumors of the pancreatic head, proximal bile duct, duodenum and ampulla, and represents the only hope of cure in cases of malignancy. Since its initial description in 1935 by Whipple et al, this complex surgical technique has evolved and undergone several modifications. We review three key issues in PD: (1) the initial approach to the superior mesenteric artery, known as the artery-first approach; (2) arterial complications caused by anatomic variants of the hepatic artery or celiac artery stenosis; and (3) the extent of lymphadenectomy.

Keywords: Artery-first; Celiac axis; Hepatic artery; Lymphadenectomy; Pancreas; Pancreaticoduodenectomy; Surgery.

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References

    1. Dumitrascu T, David L, Popescu I. Posterior versus standard approach in pancreatoduodenectomy: a case-match study. Langenbecks Arch Surg. 2010;395:677–684. - PMC - PubMed
    1. Shrikhande SV, Barreto SG, Bodhankar YD, Suradkar K, Shetty G, Hawaldar R, Goel M, Shukla PJ. Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes. Langenbecks Arch Surg. 2011;396:1205–1212. - PubMed
    1. Figueras J, Codina-Barreras A, López-Ben S, Maroto A, Torres-Bahí S, González HD, Albiol M, Falgueras L, Pardina B, Soriano J, et al. Cephalic duodenopancreatectomy in periampullary tumours. Dissection of the superior mesenteric artery as aninitial approach. Description of the technique and an assessment of our initial experience. Cir Esp. 2008;83:186–193. - PubMed
    1. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of vater. Ann Surg. 1935;102:763–779. - PMC - PubMed
    1. Varty PP, Yamamoto H, Farges O, Belghiti J, Sauvanet A. Early retropancreatic dissection during pancreaticoduodenectomy. Am J Surg. 2005;189:488–491. - PubMed

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