Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
J Hepatobiliary Pancreat Sci. 2022 Jan;29(1):99-113. doi: 10.1002/jhbp.901. Epub 2021 Mar 11.
Minimally invasive pancreatoduodenectomy (MIPD) has recently gained popularity. Several international meetings focusing on the existing literature on MIPD were held; however, the precise surgical anatomy of the pancreas for the safe use of MIPD has not yet been fully discussed. The aim of this study was to carry out a systematic review of available articles and to show the importance of identifying the anatomical variation in pancreatoduodenectomy.
In this review, we described variations in surgical anatomy related to MIPD. A systematic search of PubMed (MEDLINE) was conducted, and the references were identified manually.
The search strategy yielded 272 articles, with 77 retained for analysis. The important anatomy to be considered during MIPD includes the aberrant right hepatic artery, first jejunal vein, first jejunal artery, and dorsal pancreatic artery. Celiac artery stenosis and a circumportal pancreas are also important to recognize.
We conclude that only certain anatomical variations are associated directly with perioperative outcomes and that identification of these particular variations is important for safe performance of MIPD.
微创胰十二指肠切除术（MIPD）最近越来越受欢迎。已经举行了几次国际会议，重点讨论了关于 MIPD 的现有文献；然而，对于 MIPD 的安全使用，胰腺的确切外科解剖结构尚未得到充分讨论。本研究的目的是对现有文献进行系统回顾，并展示识别胰十二指肠切除术解剖变异的重要性。
在本综述中，我们描述了与 MIPD 相关的手术解剖学变异。对 PubMed（MEDLINE）进行了系统搜索，并手动识别了参考文献。
搜索策略产生了 272 篇文章，其中 77 篇被保留进行分析。在 MIPD 过程中需要考虑的重要解剖结构包括异常右肝动脉、第一空肠静脉、第一空肠动脉和背胰动脉。腹腔动脉狭窄和门静脉周围胰腺也是需要识别的重要结构。
我们得出的结论是，只有某些解剖变异与围手术期结果直接相关，识别这些特定的变异对于安全进行 MIPD 非常重要。
