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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (02): 133-133. doi: 10.3877/cma.j.issn.1674-3946.2023.02.005

Special Issue:

• Specialist Operation Broadcast • Previous Articles     Next Articles

Total laparoscopic radical pancreaticoduodenectomy after neoadjuvant chemotherapy(combined with superior mesenteric vein resection and artificial vascular reconstruction)

Xianlin Han1,()   

  1. 1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beiijng 100730, China
  • Online:2023-04-26 Published:2023-03-23
  • Contact: Xianlin Han
  • Supported by:
    Outstanding Youth Fund of Peking Union Medical College Hospital(JQ201701)

Abstract:

The Trocars were laid out in a conventional five-port approach. A Kocher maneuver was performed at the beginning,the inferior margin of the pancreatic neck was then dissected and the tumor invasion to the superior mesenteric vein(SMV)was evaluated. The distal stomach was resected after assessment as resectable,and the common hepatic artery was dissected and suspended as No. 8 and 12 lymphadenectomy performed,and then the gastroduodenal artery(GDA)was isolated and ligated,the gallbladder was removed with the common bile duct divided. The proximal jejunum was divided distal to the ligament of Treitz and dissected. The pancreas was subsequently divided at the neck and the splenic vein was exposed and ligated. The proximal and distal ends of the invaded SMV segments were dissected and suspended. The uncinate process was freed from the right wall of superior mesenteric artery(SMA)(in arterial-first approach). Finally,the specimen with the invaded SMV(approximately 3 cm in length)were removed during the blockage of both proximal and distal ends of the SMV. The proximal and distal ends of the SMV were then anastomosed and reconstructed using an artificial vessel with a diameter of 8 mm. The specimen was sent for pathological diagnosis. The pancreaticojejunostomy,choledochojejunostomy and gastrojejunostomy was preformed intracorporeally.

Key words: Pancreatic Neoplasms, Laparoscopes, Pancreaticoduodenectomy, Arterial-First, Artificial Vessel Reconstruction

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