Application progress of combination of multiple artery-first approaches in pancreaticoduodenectomy / 国际外科学杂志

ABSTRACT

With the improvement of modern surgical techniques and surgical instruments,combined with mutiple artery-first approaches in pancrcaticoduodenectomy,can shorten the operation time effectively,reduce intraoperative blood loss,regulate lymph node dissection,improve R0 resection rate,and thus improve the prognosis of patients,has become an important surgical treatment of pancreatic cancer and periampullary cancer.The principle of the proposed basis is mainly based on "anatomical basis no-touch concept" and " pancreatic mesorectal excision" and the combination of the main approchessuperior approach,posterior approach,interior approach (anterior approach,medial uncinate approach,mesentery approach).Pancreatic surgeons need to judge the position of the tumor and the intraoperative situation,weigh the benefits and disadvantages of each approach,so as to combine theory with practice,flexibility with principle.