ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Optimal Extent of Superior Mesenteric Artery Dissection during Pancreaticoduodenectomy for Pancreatic Cancer: Balancing Surgical and Oncological Safety.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
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48 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 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
- Trial
- ICG Fluorescence-Guided Anatomical Navigation During Robotic Pancreatoduodenectomy: Pancreatic Head Arterial Landmarks and Jejunal Mesenteric Branching.Annals of surgical oncology · 2026Article
- Mesenteric approach or conventional approach for pancreatoduodenectomy?Gland surgery · 2026Article
- Article
- Surgical Challenges Associated with Collateral Veins Formation in Pancreatic Cancer with Vein Resection.Annals of surgical oncology · 2026Article
- Article
- Learning Curve Effect in Reducing Local Recurrence Rate After Resection of Pancreatic Cancer With Arterial Abutment: A Single-Center Retrospective Study.Annals of gastroenterological surgery · 2026Article
- Diarrhea after pancreatic surgery is associated with the extent of resection: a single-center retrospective cohort-study.Langenbeck's archives of surgery · 2025Article
- Deep learning to predict extrapancreatic perineural invasion at CT images.Annals of medicine · 2025Article
- Total non-division technique of pancreaticoduodenectomy: A strategic integration of superior mesenteric artery-first approach and total mesopancreas excision.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Combined posterior and left-sided superior mesenteric artery-first approach to the TRIANGLE operation for pancreatic cancer.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Postoperative Refractory Diarrhea After Margin Accentuation of the Superior Mesenteric Artery with Irreversible Electroporation in Pancreaticoduodenectomy.Journal of clinical medicine · 2025Article
- Article
- Arterial resection and divestment in pancreatic cancer surgery in the era of multidisciplinary treatment: decadal comparative study.BJS open · 2025Article
- Mesopancreas dissection level 3 for pancreatic head cancer in combined robotic/open pancreatoduodenectomy: a propensity score-matched study.Surgical endoscopy · 2025Article
- Survival Analysis of Conversion Surgery in Borderline Resectable and Locally Advanced Unresectable Pancreatic Ductal Adenocarcinoma Addressing Selection and Immortal Time Bias: A Retrospective Single-Center Study.Annals of surgical oncology · 2024Article
- Impact of overweight on patients undergoing laparoscopic pancreaticoduodenectomy: analysis of surgical outcomes in a high-volume center.BMC surgery · 2024Article
- Impact of preoperative self-expandable metal stent on benign hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy.DEN open · 2024Article
- 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
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10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe describe the short- and long-term outcomes for PDAC patients after tailored mesopancreas dissection using supracolic artery-first approach followed by adjuvant therapy.
methodsThis study analyzed 233 consecutive patients who underwent artery-first pancreaticoduodenectomy for PDAC. Dissection extent for the superior mesenteric artery (SMA) was categorized into three levels: level 2 (LV2) including regional lymph nodes, level 3 (LV3) with hemicircumferential nerve plexus dissection, and extended-level 3 (E-LV3) including borderline resectable cases for the SMA. All clinical, pathological, and survival outcomes were reviewed.
resultsLV2/3/E-LV3 dissection was performed in 77/115/41 patients. The short-term outcomes were similar among groups without mortality. Although postoperative diarrhea requiring opioids was significantly more frequent in the E-LV3 group (76%) than other groups (vs. LV2 (21%), P < .0001; vs. LV3 (34%), P < .0001; LV2 vs. LV3, P = 0.20), most cases of diarrhea were well controlled. Adjuvant chemotherapy was introduced similarly among groups (LV2, 76%; LV3, 81%; E-LV3, 88%, P = 0.29). The 3- and 5-year overall survival rates in the LV2/3/E-LV3 groups were 42/33/42% and 27/22/26%, respectively, showing no significant difference among groups. DISCUSSION: Our tailored dissection and preemptive use of opioid antidiarrheal effectively prevents intractable diarrhea, increasing the success of adjuvant chemotherapy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.