Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing University of Medicine and Science, Chongqing 400010, China.
Hepatobiliary Pancreat Dis Int. 2010 Dec;9(6):579-83.
Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive human tumors. At present, surgical resection is the only potentially curative treatment. Early neck division is inadequate when invasion of the superior mesenteric artery (SMA) is suspected or in cases of replaced or accessory right hepatic artery. Malignant periampullary tumors often invade retroperitoneal peripancreatic tissues and a positive resection margin is associated with a poor long-term survival.
English-language medical databases, PubMed, ELSEVIER and SPRINGERLINK, were searched for articles on "posterior approach pancreaticoduodenectomy", "superior mesenteric artery first approach", "retroperitoneal tissue", "hanging maneuver", and related topics.
The modification allowed the surgeon to early identify the nonresectability of a replaced right hepatic artery if present, enabling complete dissection of the right side of the SMA and portal vein as well as complete excision of the retroportal pancreatic lamina.
Pancreaticoduodenectomy with early retropancreatic dissection is a useful and safe technical variant, which is indicated for the improvement of the safety and curative effect of the procedure.
胰腺癌仍然是癌症相关死亡的第四大主要原因，也是人类最具侵袭性的肿瘤之一。目前，手术切除是唯一有潜在治愈作用的治疗方法。当怀疑肠系膜上动脉（SMA）侵犯或存在替代或副右肝动脉时，早期颈部分离是不够的。恶性壶腹周围肿瘤常侵犯腹膜后胰周组织，阳性切缘与长期生存不良相关。
英语医学数据库、PubMed、ELSEVIER 和 SPRINGERLINK 搜索了关于“后入路胰十二指肠切除术”、“肠系膜上动脉先行法”、“腹膜后组织”、“悬挂操作”和相关主题的文章。
该改良方法可让外科医生早期识别存在时的替代右肝动脉不可切除性，从而实现 SMA 和门静脉右侧的完全解剖以及门静脉后胰腺层的完全切除。
早期胰后解剖的胰十二指肠切除术是一种有用且安全的技术变异，可提高手术的安全性和疗效。
