Systematic review of the mesopancreas: concept and clinical implications

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery

Background:

• The term mesopancreas (MP) was introduced in 2007, but its oncological implications remain under-explored.
• Limited research exists on the benefits of mesopancreas resection, necessitating further investigation.

Purpose of the Study:

• To systematically review existing literature on the mesopancreas (MP).
• To evaluate the oncological outcomes and R0 resection rates associated with MP resection.

Main Methods:

• A comprehensive electronic literature search was conducted across multiple databases (PubMed, EMBASE, Cochrane, etc.) until June 2017.
• Articles were screened for relevance, with a focus on studies describing MP resection techniques and outcomes.

Main Results:

• 28 of 51 identified articles were relevant, primarily retrospective studies focusing on technical aspects.
• R0 resection rates in MP resection cases ranged from 57% to 96.7%, generally higher than control groups.
• Survival data were reported in only five series, limiting definitive conclusions on survival benefits.

Conclusions:

• Mesopancreas (MP) excision is technically demanding but theoretically improves R0 resection rates and oncological results.
• Currently, a lack of randomized controlled trials prevents definitive proof of oncological benefit.
• Establishing a global consensus on MP definition, surgical landmarks, techniques, and outcomes is crucial.