ReviewWorld journal of gastroenterology2015
Mesopancreas: A boundless structure, namely the rationale for dissection of the paraaortic area in pancreaticoduodenectomy for pancreatic head carcinoma.
Review in World journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Radicality and safety of total mesopancreatic excision in pancreatoduodenectomy: a systematic review and meta-analysis.World journal of surgical oncology · 2024Pooled it
- Systematic review of the mesopancreas: concept and clinical implications.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018Pooled it
- Surgical and oncological implications of the presence of hepatic artery anatomical variations in patients undergoing pancreaticoduodenectomy: a single center experience.Updates in surgery · 2025Article
- Most oncological pancreas resections must consider the mesopancreas.BMC cancer · 2025Article
- Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies: A high-volume single-center experience with short-term outcomes.Annals of hepato-biliary-pancreatic surgery · 2024Article
- Challenge in optimizing robotic pancreaticoduodenectomy including nerve plexus hanging maneuver: a Japanese single center experience of 76 cases.Surgical endoscopy · 2024Article
- Article
- Strategic Approach to Aberrant Hepatic Arterial Anatomy during Laparoscopic Pancreaticoduodenectomy: Technique with Video.Journal of clinical medicine · 2023Article
- The Story Retold: The Kocher Manoeuvre.Cureus · 2022Review
- What do surgeons need to know about the mesopancreas.Langenbeck's archives of surgery · 2021Review
- Mesopancreas-new unknown land or a mirage?Langenbeck's archives of surgery · 2021Article
- Surgery for locally advanced pancreatic ductal adenocarcinoma-is it only about the vessels?Journal of gastrointestinal oncology · 2021Review
- "Mesopancreas-first" radical resection of pancreatic head cancer following the Cattell-Braasch-Valdoni maneuver: Appreciating the legacy of pioneers in visceral surgery.Annals of hepato-biliary-pancreatic surgery · 2021Article
- Follow "the superior mesenteric artery": laparoscopic approach for total mesopancreas excision during pancreaticoduodenectomy.Surgical endoscopy · 2019Article
- The lymphatic system and pancreatic cancer.Cancer letters · 2016Review
- Para-Aortic Dissection in Pancreaticoduodenectomy with Mesopancreas Excision for Pancreatic Head Carcinoma: Not Only an N-Staging Matter.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Advances in the Surgical Management of Resectable and Borderline Resectable Pancreas Cancer.Surgical oncology clinics of North America · 2016Review
- Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This review highlights the rationale for dissection of the 16a2 and 16b1 paraaortic area during pancreaticoduodenectomy (PD) for carcinoma of the head of the pancreas. Recent advances in surgical anatomy of the mesopancreas indicate that the retropancreatic area is not a single entity with well defined boundaries but an anatomical site of embryological fusion of peritoneal layers, and that continuity exists between the neuro lymphovascular adipose tissues of the retropancreatic and paraaortic areas. Recent advances in surgical pathology and oncology indicate that, in pancreatic head carcinoma, the mesopancreatic resection margin is the primary site for R1 resection, and that epithelial-mesenchymal transition-related processes involved in tumor progression may impact on the prevalence of R1 resection or local recurrence rates after R0 surgery. These concepts imply that mesopancreas resection during PD for pancreatic head carcinoma should be extended to the paraaortic area in order to maximize retropancreatic clearance and minimize the likelihood of an R1 resection or the persistence of residual tumor cells after R0 resection. In PD for pancreatic head carcinoma, the rationale for dissection of the paraaortic area is to control the spread of the tumor cells along the mesopancreatic resection margin, rather than to control or stage the nodal spread. Although mesopancreatic resection cannot be considered "complete" or "en bloc", it should be "extended as far as possible" or be "maximal", including dissection of 16a2 and 16b1 paraaortic areas.
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