ArticleAnnals of surgical oncology2025
Technical Guidelines for Safe Mesojejunum Dissection During Pancreaticoduodenectomy: Unveiling Critical Techniques in a Complex Procedure.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- ASO Author Reflections: From Vessel Visualization to Real-Time Anatomical Navigation in Robotic Pancreatoduodenectomy.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Standardization of the Left Posterior Approach for Robotic Pancreaticoduodenectomy Guided by Anatomical Principles.Annals of surgical oncology · 2026Article
- ICG Fluorescence-Guided Anatomical Navigation During Robotic Pancreatoduodenectomy: Pancreatic Head Arterial Landmarks and Jejunal Mesenteric Branching.Annals of surgical oncology · 2026Article
- Current Status and Future Perspectives of Superior Mesenteric Artery Dissection in Robotic Pancreaticoduodenectomy: A Scoping Review of Technical Variations in the Robotic Era.Journal of clinical medicine · 2025Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreaticoduodenectomy (PD) is a complex procedure involving the dissection of the superior mesenteric artery and vein. However, a safe and standardized technique for dissecting the jejunal veins (JVs) in the mesojejunum during PD remains elusive.
methodsWe retrospectively analyzed 198 patients who underwent open PD with mesojejunum dissection using an anterior artery-first approach and evaluated anatomical variations in the first JV trunk (FJVT) and its tributaries. This study introduces the concept of a "dangerous crossover vein" (DCV) to describe tributaries that cross the transection line of the mesojejunum. Surgical techniques and perioperative outcomes were assessed.
resultsThe FJVT drained the territory supplied by the first to second jejunal arteries in 144 patients (75%) and the first to third or more in 50 patients (25%). The FJVT was preserved in 100 patients (50.5%) and sacrificed in 98 (49.5%). Dangerous crossover veins were encountered in 117 patients (59%) and safely managed with standardized mesojejunal dissection. There were no significant differences in blood loss or operative time between patients with or without DCVs.
conclusionsUnderstanding the anatomy of JVs and the concept of DCVs is critical for safe mesojejunal dissection during PD. Our approach facilitates secure dissection of JVs regardless of their anatomical variations.
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