Intestinal derotation procedure for facilitating pancreatoduodenectomy

Surgery
Masanori SugiyamaToshiyuki Mori

Abstract

In pancreatoduodenectomy (PD), mesopancreas excision with division of the inferior pancreatoduodenal artery (IPDA) is technically difficult because of the complex anatomy resulting from intestinal rotation occurring during embryological development. We have developed an intestinal derotation procedure for facilitating mesopancreas excision. The perioperative factors of PD were retrospectively compared between our derotation and the conventional procedure. The entire small intestine and right colon are mobilized from the retroperitoneum, and intestinal rotation is reduced. This procedure simplifies the anatomic situation, in which (1) the mesopancreas stretches from the right side of the superior mesenteric artery (SMA) in a horizontal plane, (2) the IPDA arises from the right wall of the SMA, and (3) the SMA is situated at the right-posterior side of the superior mesenteric vein. In 232 cases undergoing PD, perioperative factors were compared retrospectively between the derotation (n = 117) and conventional (n = 115) procedure groups. The derotation procedure significantly decreased operative time (434 vs 516 minutes) and blood loss (521 vs 908 mL), and tended to increase the rate of R0 resection (90% vs 78%), compared with the...Continue Reading

References

Jul 9, 2005·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Fistula Definition
Apr 27, 2007·World Journal of Surgical Oncology·Ines GockelTheodor Junginger
Nov 28, 2007·Journal of Hepato-biliary-pancreatic Surgery·Akihiko HoriguchiShuichi Miyakawa
Jun 7, 2008·Journal of Hepato-biliary-pancreatic Surgery·Akihiko HoriguchiShuichi Miyakawa
Dec 23, 2008·American Journal of Surgery·Masanori SugiyamaYutaka Atomi
Jun 29, 2010·Langenbeck's Archives of Surgery·Thilo HackertMarkus W Büchler
May 10, 2012·The British Journal of Surgery·P SanjayJ A Windsor

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Citations

Jan 25, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ionut NegoiYosuke Inoue
Aug 21, 2020·Journal of Surgical Oncology·Edoardo Maria MuttilloPatrick Pessaux
Jun 1, 2020·World Journal of Surgery·Masanori SugiyamaNobutsugu Abe
May 29, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ryota MatsukiYoshihiro Sakamoto
Aug 17, 2020·Surgical and Radiologic Anatomy : SRA·Shuang -Qin YiXiao-Ming Lu
Apr 21, 2018·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·J M RamiaR Morales
Dec 10, 2020·The American Surgeon·Ryota MatsukiYoshihiro Sakamoto

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