Radical resection of pancreatic ductal adenocarcinoma (PDAC) requires a vessel-oriented
approach, because of the close anatomic relationships with retroperitoneal vessels
and the high frequency of extrapancreatic nerve plexus (ENP) invasion. Therefore,
pancreatic surgeons should be familiar with vascular surgery techniques. This is the
vision of a pancreatic surgeon who also performs transplants and received training
in vascular surgery. On practical grounds, I never left a macroscopic tumor residual
in over 2,000 pancreatic resections. Avoiding R2 resection requires careful preoperative
planning and selection. I have performed more than 550 vascular resections, including
more than 150 arterial resections. However, approximately 50% of my pancreatoduodenectomies
(PDs) for PDAC are R1.
1
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A propensity score-matched analysis of robotic versus open pancreatoduodenectomy for pancreatic cancer based on margin status.Surg Endosc. 2019; 33: 234-242
- Impact of the aberrant right hepatic artery on local recurrence of pancreatic ductal adenocarcinoma after pancreaticoduodenectomy.Surgery. 2022; 172: 691-699
- Landmark series: importance of pancreatic resection margins.Ann Surg Oncol. 2022; 29: 1542-1550
- Resection margins in pancreatic cancer.Surg Clin North Am. 2013; 93: 647-662
- Multicenter randomized phase II trial of prophylactic right-half dissection of superior mesenteric artery nerve plexus in pancreatoduodenectomy for pancreatic head cancer.Ann Gastroenterol Surg. 2020; 5: 111-118
Article info
Publication history
Published online: May 07, 2022
Accepted:
April 5,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Impact of the aberrant right hepatic artery on local recurrence of pancreatic ductal adenocarcinoma after pancreaticoduodenectomySurgeryVol. 172Issue 2
- PreviewThe influence and risk associated with an aberrant right hepatic artery, a common anatomical variation, during pancreatoduodenectomy for pancreatic ductal adenocarcinoma has not been fully investigated. The present study analyzed the impact of an aberrant right hepatic artery on local recurrence after pancreatoduodenectomy for pancreatic ductal adenocarcinoma.
- Full-Text
- Preview
