Tips of laparoscopic pancreaticoduodenectomy: superior mesenteric artery first approach (with video)
In previous reports of laparoscopic pancreaticoduodenectomy, the Kocher maneuver with a wide mobilization of the right colonic flexure is carried out in the early phase, and dissection of the superior mesenteric artery is performed in the last phase of resection. This report describes laparoscopic s...
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Published in | Journal of hepato-biliary-pancreatic sciences Vol. 21; no. 3; pp. E19 - E21 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Japan
Blackwell Publishing Ltd
01.03.2014
Wiley Subscription Services, Inc |
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Abstract | In previous reports of laparoscopic pancreaticoduodenectomy, the Kocher maneuver with a wide mobilization of the right colonic flexure is carried out in the early phase, and dissection of the superior mesenteric artery is performed in the last phase of resection. This report describes laparoscopic superior mesenteric artery first approach, in which the superior mesenteric artery is dissected in the early phase of resection. Through the ligament of Treitz, the retroperitoneum is widely opened and the superior mesenteric artery is isolated just superior to the left renal vein. The periarterial connective tissue and nerve plexuses surrounding the superior mesenteric artery are dissected longitudinally to identify the inferior pancreaticoduodenal artery, which is then tied and divided. The superior mesenteric artery first approach and early ligation of the inferior pancreaticoduodenal artery is considered to be a feasible, safe, and effective method for performing pure laparoscopic pancreaticoduodenectomy. |
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AbstractList | In previous reports of laparoscopic pancreaticoduodenectomy, the Kocher maneuver with a wide mobilization of the right colonic flexure is carried out in the early phase, and dissection of the superior mesenteric artery is performed in the last phase of resection. This report describes laparoscopic superior mesenteric artery first approach, in which the superior mesenteric artery is dissected in the early phase of resection. Through the ligament of Treitz, the retroperitoneum is widely opened and the superior mesenteric artery is isolated just superior to the left renal vein. The periarterial connective tissue and nerve plexuses surrounding the superior mesenteric artery are dissected longitudinally to identify the inferior pancreaticoduodenal artery, which is then tied and divided. The superior mesenteric artery first approach and early ligation of the inferior pancreaticoduodenal artery is considered to be a feasible, safe, and effective method for performing pure laparoscopic pancreaticoduodenectomy. Abstract In previous reports of laparoscopic pancreaticoduodenectomy, the K ocher maneuver with a wide mobilization of the right colonic flexure is carried out in the early phase, and dissection of the superior mesenteric artery is performed in the last phase of resection. This report describes laparoscopic superior mesenteric artery first approach, in which the superior mesenteric artery is dissected in the early phase of resection. Through the ligament of T reitz, the retroperitoneum is widely opened and the superior mesenteric artery is isolated just superior to the left renal vein. The periarterial connective tissue and nerve plexuses surrounding the superior mesenteric artery are dissected longitudinally to identify the inferior pancreaticoduodenal artery, which is then tied and divided. The superior mesenteric artery first approach and early ligation of the inferior pancreaticoduodenal artery is considered to be a feasible, safe, and effective method for performing pure laparoscopic pancreaticoduodenectomy. |
Author | Kainuma, Osamu Cho, Akihiro Yamamoto, Hiroshi |
Author_xml | – sequence: 1 givenname: Akihiro surname: Cho fullname: Cho, Akihiro email: acho@chiba-cc.jp organization: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chiba, 260-8717, Chuouku, Japan – sequence: 2 givenname: Hiroshi surname: Yamamoto fullname: Yamamoto, Hiroshi organization: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chiba, 260-8717, Chuouku, Japan – sequence: 3 givenname: Osamu surname: Kainuma fullname: Kainuma, Osamu organization: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chiba, 260-8717, Chuouku, Japan |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24307512$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1007/s00423-011-0824-5 10.1016/j.jamcollsurg.2012.08.006 10.5754/hge11351 10.1001/archsurg.2010.120 10.1007/s00464-012-2427-9 10.1016/j.gassur.2005.05.001 10.1016/j.amjsurg.2008.12.025 10.1007/s00534-006-1198-x 10.1089/lap.2009.0412 10.1001/archsurg.2009.243 10.1097/01.sla.0000258607.17194.2b 10.1007/s00268-010-0755-2 10.1007/s00464-005-0474-1 10.1016/j.jamcollsurg.2007.04.004 10.1016/j.jamcollsurg.2009.10.019 10.1007/BF00642443 10.1007/s00423-009-0499-3 |
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Keywords | Superior mesenteric artery first Laparoscopic pancreaticodoudenectomy Pancreaticodoudenectomy Laparoscopy |
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short‐term outcome publication-title: World J Surg – volume: 27 start-page: 95 year: 2013 end-page: 103 article-title: Short‐term clinical outcomes for 100 consecutive cases of laparoscopic pylorus‐preserving pancreaticoduodenectomy: improvement with surgical experience publication-title: Surg Endosc – volume: 205 start-page: 222 year: 2007 end-page: 230 article-title: Laparoscopic pancreaticoduodenectomy: technique and outcomes publication-title: J Am Coll Surg – volume: 10 start-page: 607 year: 2006 end-page: 611 article-title: Pancreaticoduodenectomy: superior mesenteric artery first approach publication-title: J Gastrointest Surg – volume: 210 start-page: e1 year: 2010 end-page: 4 article-title: The “artery first” approach for resection of pancreatic head cancer publication-title: J Am Coll Surg – volume: 12 start-page: 220 year: 2011 end-page: 229 article-title: Left posterior approach to the superior mesenteric vascular pedicle in pancreaticoduodenectomy for cancer of the pancreatic head publication-title: JOP – volume: 14 start-page: 575 year: 2007 end-page: 578 article-title: Pancreatoduodenectomy in which dissection of the efferent arteries of the head of the pancreas is performed first publication-title: J Hepatobiliary Pancreat Surg – volume: 145 start-page: 19 year: 2010 end-page: 23 article-title: Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience publication-title: Arch Surg – volume: 8 start-page: 408 year: 1994 end-page: 410 article-title: Laparoscopic pylorus‐preserving pancreatoduodenectomy publication-title: Surg Endosc – volume: 145 start-page: 616 year: 2010 end-page: 621 article-title: Laparoscopic vs open distal pancreatectomy: a single‐institution comparative study publication-title: Arch Surg – volume: 396 start-page: 1205 year: 2011 end-page: 1212 article-title: Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes publication-title: Langenbecks Arch Surg – volume: 59 start-page: 570 year: 2012 end-page: 573 article-title: A non‐randomized comparative study of laparoscopy‐assisted pancreaticoduodenectomy and open pancreaticoduodenectomy publication-title: Hepatogastroenterology – volume: 215 start-page: 810 year: 2012 end-page: 819 article-title: Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the Accordion Severity Grading System publication-title: J Am Coll Surg – volume: 246 start-page: 77 year: 2007 end-page: 82 article-title: Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients publication-title: Ann Surg – volume: 51 start-page: 4 year: 2004 end-page: 5 article-title: Early ligation of the inferior pancreaticoduodenal artery to reduce blood loss during pancreaticoduodenectomy publication-title: Hepatogastroenterology – ident: 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Snippet | In previous reports of laparoscopic pancreaticoduodenectomy, the Kocher maneuver with a wide mobilization of the right colonic flexure is carried out in the... Abstract In previous reports of laparoscopic pancreaticoduodenectomy, the K ocher maneuver with a wide mobilization of the right colonic flexure is carried out... |
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SubjectTerms | Adenosine Humans Laparoscopic pancreaticodoudenectomy Laparoscopy Laparoscopy - methods Mesenteric Artery, Superior Pancreaticodoudenectomy Pancreaticoduodenectomy - methods Superior mesenteric artery first Veins & arteries |
Title | Tips of laparoscopic pancreaticoduodenectomy: superior mesenteric artery first approach (with video) |
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