Abstract:

In addition to hematogenous and lymphatic metastasis, pancreatic head cancer is also prone to nerve invasion. The standard pancreaticoduodenectomy cannot achieve a clearance of the nerve plexus around the pancreas. Currently, there is no unified standard for the surgical indications and scope of the extended pancreaticoduodenal. Under the guidance of Professor Wang Huaizhi, our center has been performing extended pancreaticoduodenectomy for the treatment of pancreatic head cancer for more than 10 years. The procedure requires a complete skeletonization clearance of the posterior aspect of the pancreatic head, superior mesenteric artery, celiac trunk, and hepatic artery within a 360° range. In recent years, laparoscopic pancreaticoduodenectomy has developed rapidly. Following the standards of open extended pancreaticoduodenectomy, our center performs laparoscopic extended pancreaticoduodenectomy with superior mesenteric artery-first approach for the treatment of pancreatic head cancer. During the procedure we ligate and cut off the inferior pancreaticoduodenal artery first, thereby cutting off the arterial blood supply to the pancreatic head. It then deals with the superior mesenteric vein and portal vein tributaries, reducing bleeding and achieving the complete removal of the lesion, retroperitoneal neural and lymphatic tissues.

Key words: Pancreatic Head Cancer, Pancreaticoduodenectomy, Laparoscopes