Abstract:

Dissect the upper edge of the pancreas, free the common hepatic artery and gastroduodenal artery, ligate and disconnect the gastroduodenal artery, and then dissect the superior mesenteric vein (SMV) of the lower edge of the pancreas. At this time, we can evaluate whether the venous root is invaded and determine whether the tumor can be resected, then open the pancreatic tunnel and disconnect the pancreas; The duodenum and pancreatic head were fully free through Kocher incision, and the soft tissue at the angle of left renal vein and inferior vena cava was cleaned, after jejunum was cut off; SMV (superior mesenteric vein) and SMA (superior mesenteric artery) were suspended freely with SMV-PV (portal vein) as the axis, so as to provide sufficient exposure and tissue tension for the treatment of uncinate process by arteriovenous crossing technique. At this time, the right side of SMA-CA (Celiac trunk) axis was 180° to the CA root. Pancreaticojejunostomy with " three needle method" is a simple technique with short time. There is no difference in the rate of pancreatic fistula between the two methods. After pancreaticojejunostomy, choledochojejunostomy and gastrointestinal anastomosis, the whole specimen was taken out.

Key words: Pancreatic neoplasms, Pancreaticoduodenectomy, Laparoscopes, Lymph node excision