ArticleLangenbeck's archives of surgery2017
Laparoscopic uncinate process first pancreatoduodenectomy-feasibility study of a modified 'artery first' approach to pancreatic head cancer.
Article in Langenbeck's archives of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Phenotypic heterogeneity and tumor immune microenvironment directed therapeutic strategies in pancreatic ductal adenocarcinoma.Frontiers in immunology · 2025Review
- Oncological Outcomes of Open Versus Minimally Invasive Surgery for Ductal Adenocarcinomas of Pancreatic Head: A Propensity Score Matching Analysis.Current oncology (Toronto, Ont.) · 2024Article
- Application of the superior mesenteric artery-first approach in laparoscopic pancreatoduodenectomy: A literature review.Heliyon · 2024Review
- Article
- Strategic Approach to Aberrant Hepatic Arterial Anatomy during Laparoscopic Pancreaticoduodenectomy: Technique with Video.Journal of clinical medicine · 2023Article
- State-of-the-art surgery for pancreatic cancer.Langenbeck's archives of surgery · 2022Review
- Korean Surgical Practice Guideline for Pancreatic Cancer 2022: A summary of evidence-based surgical approachesAnnals of hepato-biliary-pancreatic surgery · 2022Article
- An anatomical review of various superior mesenteric artery-first approaches during pancreatoduodenectomy for pancreatic cancer.Surgery today · 2021Review
- Surgical Treatment of Pancreatic Ductal Adenocarcinoma.Cancers · 2021Review
- Operative technique in robotic pancreaticoduodenectomy (RPD) at University of Illinois at Chicago (UIC): 17 steps standardized technique : Lessons learned since the first worldwide RPD performed in the year 2001.Surgical endoscopy · 2018Article
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Authors and funding
9 authors.
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Abstract
purposeThe aim of this study was to discuss the feasibility of laparoscopic 'uncinate first' pancreatoduodenectomy.
methodsThe analysis included prospectively collected data from 12 consecutive patients undergoing elective pure laparoscopic 'uncinate process first' pancreatoduodenectomy (Group 1). They were compared with patients previously operated on with a classical laparoscopic approach (Group 2). The primary outcome was the quality of the resected specimen (lymph node (LN) yield, R0 rate, involved resection margins). Secondary outcomes were perioperative parameters.
resultsThe LN yield in Group 1 was 19.3 and in Group 2 it was 13.9 (p = 0.03). R0 resection rates did not vary (66.7 vs. 63.2%, p = 0.84). Although the involvement of the superior mesenteric artery margin and uncinate process margin seemed lower in Group 1, the difference was not significant. Total operative time (467 vs. 425 min, p = 0.13) and resection time (221 vs. 232 min, p = 0.34) were similar in both groups. The estimated blood loss in Group 1 was 408 ml, whereas in Group 2 it was 392 ml (p = 0.33). Complication rates were 66.7% in Group 1 and 63.2% in Group 2 (p = 0.84). Median length of stay was 9 days in both groups (p = 0.36). Postoperative complication rates did not differ between groups.
conclusionsLaparoscopic uncinate first approach is a feasible method for pancreatic head neoplasms. Achieved quality of the specimen is comparable with the traditional laparoscopic approach, whereas intra- and postoperative course is not inferior. However, further studies on larger cohorts are required to fully establish whether the novel approach has potential advantages over classical access in pancreatic head cancer.
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