Related Experiment Video
Updated: Mar 22, 2026
Application of Robot-assisted Pancreaticobiliary Junction Resection in Benign Duodenal Tumors
Published on: December 20, 2024
Total meso-pancreatoduodenum excision with pancreaticoduodenectomy in lower biliary tract cancer
Yasunari Kawabata1, Hikota Hayashi2, Noriyoshi Ishikawa3
1Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan. manyu3310@yahoo.co.jp.
Background:
Incomplete tumor resection with insufficient lymphadenectomy following a pancreaticoduodenectomy (PD) for lower biliary tract cancer results in a dismal outcome. This study aimed to compare the short-term outcomes of PD between total meso-pancreatoduodenum excision (tMPDe) and the conventional procedure for lower biliary tract cancer.
Methods:
Patients who underwent PD for lower biliary tract cancer between May 2003 and March 2015 were included in this study. We have devised a new surgical technique, tMPDe, as a mesenteric plane surgery with an artery-first approach, for achieving complete clearance of the peripancreatic retroperitoneal tissue and lymph nodes. Perioperative data, including complications and short-term survival, were evaluated.
Results:
A total of 74 consecutive patients underwent a PD: 41 patients underwent conventional PD (cPD), and 33 underwent tMPDe. The tumor stages were similar in the two study groups. R0 was achieved in 32 patients (78.0 %) with cPD and in 31 patients (93.9 %) with tMPDe (p = 0.046). The survival rates at 1 and 3 years after surgery were 82.5 and 64.0 % for the cPD group, with a median follow-up period of 44.6 months, and 92.8 and 84.4 % for the tMPDe group, with a median follow-up period of 28.6 months, respectively.
Conclusions:
The tMPDe technique significantly increased R0 resection and contributed to better oncological outcomes in lower biliary tract cancer.
