Application of Artery First Approach for Pancreaticodudenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GAOWen-tao , JIANGKui-rong , WUJun-li , QIANZhu-yin , DAICun-cai , LIQiang ,  MIAOYi

Pancreatic Surgery Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China;

Corresponding author：

MIAOYi, Email: miaoyi@njmu.edu.cn

Keywords：

Pancreaticodudenectomy; Artery first; Superior mesenteric artery

DOI：

10.7507/1007-9424.20140193

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the application of artery first approach in pancreaticodudenectomy, aiming to explore superior mesenteric artery(SMA) and celiac axis in early stage of operation, confirming the resectability and achieving radical resection of the nervous and lymphatic tissues around axis of celiac artery and SMA. Methods The data of 27 patients with suspected carcinoma in pancreatic head who received the artery first approach in pancreaticodudenectomy from Sep, 2009 to Dec, 2013 in our hospital were retrospectively analyized. Results Eight cases received palliative drainage operation, while other 19 cases received radical pancreatectomy, including 2 cases total pancreatectomy and 17 cases pancreaticodudenectomy, with 5 cases portal vein or superior mesenteric vein resection and reconstruction, 1 case common hepatic artery resection, and 2 cases extended right pancreatectomy. The operative time was(281.28±78.53) min(133-354 min), and amount of bleeding was(352±537) mL(189-1 352 mL). There were no operative death, and no reoperation due to complications. Conclusion Artery first approach is preferred for patients with borderline resectable tumors, pancreatic surgeon should be familiar to the various approach.

Citation： GAOWen-tao, JIANGKui-rong, WUJun-li, QIANZhu-yin, DAICun-cai, LIQiang, MIAOYi. Application of Artery First Approach for Pancreaticodudenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(7): 802-808. doi: 10.7507/1007-9424.20140193 Copy

1.	Makino I, Kitagawa H, Ohta T, et al. Nerve plexus invasion in pancreatic cancer:spread patterns on histopathologic and embryological analyses[J]. Pancreas, 2008, 37(4):358-365.
2.	Hishinuma S, Ogota Y, Tomikawa M, et al. Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy studies[J]. J Gastrointest Surg, 2006, 10(4):511-518.
3.	Bilimoria K, Talamonti M, Sener S, et al. Effect of hospital volume on margin status after pancreaticoduodenectomy for cancer[J]. J Am Coll Surg, 2008, 207(4):510-519.
4.	NCCN clinical practice guideline in oncology for pancreatic adenocarcinoma, National Comprehensive Cancer Networks (NCCN) (2013)[EB/OL]. http://www.nccn.org.
5.	Valls C, Andía E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma:assessment of resectability before surgery[J]. AJR Am J Roentgenol, 2002, 178(4):821-826.
6.	Callery MP, Chang KJ, Fishman EK, et al. Pretreatment assessment of resectable and borderline resectable pancreatic cancer: expert consensus statement[J]. Ann Surg Oncol, 2009, 16(7): 1727-1733.
7.	Pessaux P, Regenet N, Arnaud JP. Resection of the retroportal pancreatic lamina during pancreatoduodenectomy:first dissection of the superior mesenteric artery[J]. Ann Chir, 2003, 128(9): 633-636.
8.	Dumitrascu T, David L, Popescu I. Posterior versus standard approach in pancreatoduodenectomy-a case-match study[J]. Langenbecks Arch Surg, 2010, 395(6):677-684.
9.	Sanjay P, Takaori K, Govil S, et al. 'Artery-first' approaches to pancreatoduodenectomy[J]. Br J Surg, 2012, 99(8):1027-1035.
10.	Shrikhande SV, Barreto SG, Bodhankar YD, et al. Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes[J]. Langenbecks Arch Surg, 2011, 396(8):1205-1212.
11.	Pessaux P, Varma D, Arnaud JP. Pancreaticoduodenectomy: superior mesenteric artery first approach[J]. J Gastrointest Surg, 2006, 10(4):607-611.
12.	Pessaux P, Rosso E, Panaro F, et al. Preliminary experience with the hanging maneuver for pancreaticoduodenectomy[J]. Eur J Surg Oncol, 2009, 35(9):1006-1010.
13.	Weitz J, Rahbari N, Koch M, et al. The "artery first" approach for resection of pancreatic head cancer[J]. J Am Coll Surg, 2010, 210(2):e1-e4.
14.	Kurosaki I, Minagawa M, Takano K, et al. Left posterior approach to the superior mesenteric vascular pedicle in pancreaticoduodenectomy for cancer of the pancreatic head[J]. JOP, 2011, 12(3):220-229.
15.	Shukla PJ, Barreto G, Pandey D, et al. Modification in the technique of pancreaticoduodenectomy:supracolic division of jejunum to facilitate uncinate process dissection[J]. Hepatogastroenterology, 2007, 54(78):1728-1730.
16.	Hackert T, Werner J, Weitz J, et al. Uncinate process first-a novel approach for pancreatic head resection[J]. Langenbecks Arch Surg, 2010, 395(8):1161-1164.
17.	Rose JB, Rocha F, Alseidi A, et al. Posterior'superior mesenteric artery first'approach for resection of locally advanced pancreatic cancer[J]. Ann Surg Oncol, 2014, 21(6):1927-1928.
18.	Iqbal N, Lovegrove RE, Tilney HS, et al. A comparison of pancreaticoduodenectomy with extended pancreaticoduodenectomy: a meta-analysis of 1909 patients[J]. Eur J Sur Onco, 2009, 359(1):79-86.
19.	Pessaux P, Marzano E, Rosso E. A plea for the artery-first dissection during pancreaticoduodenectomy[J]. J Am Coll Surg, 2010, 211(1):142-143.
20.	Cho A, Yamamoto H, Kainuma O. Tips of laparoscopic pancreaticoduodenectomy:superior mesenteric artery first approach (with video)[J]. J Hepatobiliary Pancreat Sci, 2014, 21(3):E19-E21.

1. Makino I, Kitagawa H, Ohta T, et al. Nerve plexus invasion in pancreatic cancer:spread patterns on histopathologic and embryological analyses[J]. Pancreas, 2008, 37(4):358-365.
2. Hishinuma S, Ogota Y, Tomikawa M, et al. Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy studies[J]. J Gastrointest Surg, 2006, 10(4):511-518.
3. Bilimoria K, Talamonti M, Sener S, et al. Effect of hospital volume on margin status after pancreaticoduodenectomy for cancer[J]. J Am Coll Surg, 2008, 207(4):510-519.
4. NCCN clinical practice guideline in oncology for pancreatic adenocarcinoma, National Comprehensive Cancer Networks (NCCN) (2013)[EB/OL]. http://www.nccn.org.
5. Valls C, Andía E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma:assessment of resectability before surgery[J]. AJR Am J Roentgenol, 2002, 178(4):821-826.
6. Callery MP, Chang KJ, Fishman EK, et al. Pretreatment assessment of resectable and borderline resectable pancreatic cancer: expert consensus statement[J]. Ann Surg Oncol, 2009, 16(7): 1727-1733.
7. Pessaux P, Regenet N, Arnaud JP. Resection of the retroportal pancreatic lamina during pancreatoduodenectomy:first dissection of the superior mesenteric artery[J]. Ann Chir, 2003, 128(9): 633-636.
8. Dumitrascu T, David L, Popescu I. Posterior versus standard approach in pancreatoduodenectomy-a case-match study[J]. Langenbecks Arch Surg, 2010, 395(6):677-684.
9. Sanjay P, Takaori K, Govil S, et al. 'Artery-first' approaches to pancreatoduodenectomy[J]. Br J Surg, 2012, 99(8):1027-1035.
10. Shrikhande SV, Barreto SG, Bodhankar YD, et al. Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes[J]. Langenbecks Arch Surg, 2011, 396(8):1205-1212.
11. Pessaux P, Varma D, Arnaud JP. Pancreaticoduodenectomy: superior mesenteric artery first approach[J]. J Gastrointest Surg, 2006, 10(4):607-611.
12. Pessaux P, Rosso E, Panaro F, et al. Preliminary experience with the hanging maneuver for pancreaticoduodenectomy[J]. Eur J Surg Oncol, 2009, 35(9):1006-1010.
13. Weitz J, Rahbari N, Koch M, et al. The "artery first" approach for resection of pancreatic head cancer[J]. J Am Coll Surg, 2010, 210(2):e1-e4.
14. Kurosaki I, Minagawa M, Takano K, et al. Left posterior approach to the superior mesenteric vascular pedicle in pancreaticoduodenectomy for cancer of the pancreatic head[J]. JOP, 2011, 12(3):220-229.
15. Shukla PJ, Barreto G, Pandey D, et al. Modification in the technique of pancreaticoduodenectomy:supracolic division of jejunum to facilitate uncinate process dissection[J]. Hepatogastroenterology, 2007, 54(78):1728-1730.
16. Hackert T, Werner J, Weitz J, et al. Uncinate process first-a novel approach for pancreatic head resection[J]. Langenbecks Arch Surg, 2010, 395(8):1161-1164.
17. Rose JB, Rocha F, Alseidi A, et al. Posterior'superior mesenteric artery first'approach for resection of locally advanced pancreatic cancer[J]. Ann Surg Oncol, 2014, 21(6):1927-1928.
18. Iqbal N, Lovegrove RE, Tilney HS, et al. A comparison of pancreaticoduodenectomy with extended pancreaticoduodenectomy: a meta-analysis of 1909 patients[J]. Eur J Sur Onco, 2009, 359(1):79-86.
19. Pessaux P, Marzano E, Rosso E. A plea for the artery-first dissection during pancreaticoduodenectomy[J]. J Am Coll Surg, 2010, 211(1):142-143.
20. Cho A, Yamamoto H, Kainuma O. Tips of laparoscopic pancreaticoduodenectomy:superior mesenteric artery first approach (with video)[J]. J Hepatobiliary Pancreat Sci, 2014, 21(3):E19-E21.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Artery First Approach for Pancreaticodudenectomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content