Advantages of the Maneuver of Intestinal Derotation for Pancreaticoduodenectomy

Abstract

Our data are in keeping with the classical PDs performed without ID. The association of the maneuver of ID with PD seems to bring some important advantages such as wider exposure of the operative field, safer dissection of anatomical structures, less intraoperative blood loss and higher number of sampled lymph nodes.

“Mesopancreas-first” radical resection of pancreatic head cancer following the Cattell–Braasch–Valdoni maneuver: Appreciating the legacy of pioneers in visceral surgery

“…During the last decade, there has been a number of important reports on the use and advantages of the Cattell-Braasch-Valdoni maneuver in pancreatic head cancer surgery [39][40][41]. According to these reports, the underlying reason for the implementation of this maneuver in PD lies in the fact that it reverses the embryologically twisted duodenojejunal junction, creating a new favorable anatomical condition, enabling improved surgical exposure of the pancreaticoduodenal complex and proximal jejunum.…”

Cattell‐Braasch maneuver facilitates the artery‐first approach and complete excision of the mesopancreas for pancreatoduodenectomy

“…We think that the difficulty of PD procedures is caused by this distortion between the duodenum and SMA/SMV, and this maneuver could resolve this difficulty. Some surgeons named this technique “the intestinal derotation procedure” and also applied it to PD 16,17 . However, the usefulness of this technique remains unclear.…”

Endoscopic Study of the Function of the Junction and the Timing of Epithelialization of the Pancreatogastric Anastomosis After Pancreatoduodenectomy

“…В наш час, з розвитком візуалізаційних методів діагностики, хірургічної техніки та післяопераційного лікування, рівень смертності знизився до 1-3%, однак післяопераційна захворюваність, залишається відносно високою і досягає до 65% [3].…”