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. 2022 Jan;29(1):114-123.
doi: 10.1002/jhbp.905. Epub 2021 Feb 18.

Surgical approaches to the superior mesenteric artery during minimally invasive pancreaticoduodenectomy: A systematic review

Yuichi Nagakawa  1 , Yusuke Watanabe  2 , Shingo Kozono  1 , Ugo Boggi  3 , Chinnusamy Palanivelu  4 , Rong Liu  5 , Shin-E Wang  6 , Jin He  7 , Hitoe Nishino  1 , Takao Ohtsuka  8 , Daisuke Ban  9 , Kohei Nakata  2 , Itraru Endo  10 , Akihiko Tsuchida  1 , Masafumi Nakamura  2 ; Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)
Collaborators, Affiliations

Surgical approaches to the superior mesenteric artery during minimally invasive pancreaticoduodenectomy: A systematic review

Yuichi Nagakawa et al. J Hepatobiliary Pancreat Sci. 2022 Jan.

Abstract

Background: Minimally invasive pancreaticoduodenectomy (MIPD) has recently been safely performed by experts, and various methods for resection have been reported. This review summarizes the literature describing surgical approaches for MIPD.

Methods: A systematic literature search of PubMed (MEDLINE) was conducted for studies reporting robotic and laparoscopic pancreaticoduodenectomy; the reference lists of review articles were searched. Of 444 articles yielded, 23 manuscripts describing the surgical approach to dissect around the superior mesenteric artery (SMA), including hand-searched articles, were assessed.

Results: Various approaches to dissect around the SMA have been reported. These approaches were categorized according to the direction toward the SMA when initiating dissection around the SMA: anterior approach (two articles), posterior approach (four articles), right approach (16 articles), and left approach (three articles). Thus, many reports used the right approach. Most articles provided a technical description. Some articles showed the advantage of their method in a comparison study. However, these were single-center retrospective studies with a small sample size.

Conclusions: Various approaches for MIPD have been reported; however, few authors have reported the advantage of their methods compared to other methods. Further discussion is needed to clarify the appropriate surgical approach to the SMA during MIPD.

Keywords: artery-first approach; laparoscopic pancreaticoduodenectomy; minimally invasive pancreaticoduodenectomy; robot-assisted pancreaticoduodenectomy; superior mesenteric artery.

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References

REFERENCES

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