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Updated: May 3, 2026
Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer Using In-Situ No-Touch Isolation Technique
Published on: February 2, 2022
Early retropancreatic lamina dissection during pancreaticoduodenectomy: how, when and why?
C Lupaşcu1, Corina Ursulescu2, N Dănilă3
1Discipline of Surgery, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, Iaşi.
Unlabelled:
Pancreaticoduodenectomy is the procedure of choice for tumors of the pancreatic head and periampullary region. During pancreaticoduodenectomy, early neck division may be inadequate in case of hepatic artery anatomic variants, suspected involvement of the superior mesenteric vessels or intraductal papillary mucinous neoplasms.
Material And Methods:
We describe our early approach to the superior mesenteric vessels during pancreaticoduodenectomy, by retroportal lamina dissection before pancreatic transection.
Results:
We used this approach in 41 patients. There were 28 patients with abnormal hepatic artery, which was spared in 26 cases. Hepatic artery reconstruction was required in 2 cases. Nine patients with intraductal papillary mucinous neoplasms underwent 6 pancreaticoduodenectomies extented to the body and 3 total pancreaticoduodenectomies. Four patients with adenocarcinoma involving the portomesenteric vein required pancreaticoduodenectomy with venous resection and reconstruction.
Conclusions:
Early retropancreatic lamina dissection is useful way to tailor a pancreaticoduodenectomy which is recommended in selective indications.
