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| 1 | Pancreaticoduodenectomy with early superior mesenteric artery dissection显示文摘BACKGROUND: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. DATA SOURCES: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. RESULTS: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. CONCLUSION:Pancreaticoduodenectomy with early retro-pancreatic dissection is a useful and safe technical variant, which is indicated for the improvement of the safety and curative effect of the procedure. | Xu, Yu-Fei Liu, Zuo-Jin Gong, Jian-Ping | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，6： | 4 |
| 2 | Extended pancreatic resections and lymphadenectomy:An appraisal of the current evidence显示文摘Surgery remains the mainstay of treatment for pancreatic ductal adenocarcinoma and complete removal of the cancer confers a definite survival advantage,especially in early disease.However,the majority of patients do not present with early disease,thus precluding the chance of a cure by standard pancreatoduodenectomy(PD),distal pancreatectomy or total pancreatectomy.For this reason,pancreatic surgeons have attempted to push the limits of resection over the last three decades.The aim of these resections has been to determine whether obtaining a complete resection by extending the limits of conventional resection in patients with advanced disease will yield the results seen with PD alone in early disease.This article revisits the data from such studies in an attempt to determine if the available literature supports the performance of extended resections for pancreatic cancer in terms of improvement of survival. | Shailesh V Shrikhande Savio G Barreto | 2010 | World Journal of Gastrointestinal Surgery2010，2，2： | 2 |
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