Pancreatoduodenectomy using a no-touch isolation technique

Hirota, Masahiko; Kanemitsu, Keiichiro; Takahashi, Hiroshi; Chikamoto, Akira; Tanaka, Hiroshi; Sugita, Haruo; Sand, Juhani; Nordback, Isto; Baba, Hideo

doi:10.1016/j.amjsurg.2008.06.035

Cited by 68 publications

(46 citation statements)

References 16 publications

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“…Hirota et al proposed a "notouch" technique wherein vessels are dissection first before mobilizing the tumor for pancreatic head tumors. This was proposed mainly for patients undergoing en-bloc superior mesenteric and portal vein resection [28]. Kawabata et al described a total meso-pancreatoduodenum excision (tMPDe) in which a circumferential lymphadenectomy around the SMA together with mesopancreas was performed.…”

Section: Technical Modifications Proposed For Better Resection Of Mesmentioning

confidence: 99%

“…Though the postoperative mortality had decreased from 20 % to 5 % in most of the centers, the 5 year survival varied from 5 to 20 % [22,27]. R0 resection varied from 20 % to 90 % depending on the method of histopathological examination [28][29][30][31][32]. The most commonly involved margins were the medial margins (60-80 %) and the posterior margins [22].…”

Section: Review Of Literaturementioning

confidence: 99%

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Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Ramachandra

Challa

2014

Indian J Surg Oncol

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Pancreatic cancer is associated with poor prognosis and surgery remains the main modality of treatment. Negative resection margin is an important prognostic factor for survival. Retropancreatic margin or the medial margin is the most common site of positive resection margin. Mesopancreas was proposed in analogy with mesorectum, which is considered as a fusion fascia formed embryologically during the development of pancreas. This mesopancreas lies posterior to the pancreas and contains pancreaticoduodenal vessels, lymphatics, nerve plexus and loose areolar tissue. Various technical modifications were proposed for better dissection of mesopancreas like posterior approach and artery first approach. There is an increased rate of R0 resection by these technical modifications but whether this will turn to increase in survival rates is yet to be established.

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Section: Technical Modifications Proposed For Better Resection Of Mesmentioning

confidence: 99%

Section: Review Of Literaturementioning

confidence: 99%

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Ramachandra

Challa

2014

Indian J Surg Oncol

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“…Squeezing and handling the tumor prior to ligation of the surrounding vessels during pancreatectomy may increase the risk of shedding cancer cells into the portal vein, retroperitoneum and/or peritoneal cavity. Although the no-touch isolation technique has not been shown to increase cancer survival or decrease recurrence, it is theoretically promising (Hirota et al, 2005;Hirota et al, 2010). Another aim is to resect cancers by wrapping them within Gerota's fascia.…”

Section: Laparoscopy-assisted Distal Pancreatectomy For Invasive Pancmentioning

confidence: 99%

Laparoscopy-Assisted Distal Pancreatectomy

Hirota¹,

Hashimoto²,

Sakata³

et al. 2011

Updated Topics in Minimally Invasive Abdominal Surgery

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“…Inferior supracolic/anterior approach Hirota et al [15] described PD using a "no-touch isolation technique", to avoid compression of the tumor and the spread of malignant cells within the abdominal cavity. The tumor is wrapped in Gerota's fascia and the retroperitoneal margin dissected along the right side of the SMA and the abdominal aorta.…”

Section: Posterior Approachmentioning

confidence: 99%

Tricks and tips in pancreatoduodenectomy

Pallisera

Morales

Ramia

2014

WJGO

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Author contributions: Pallisera A wrote the introduction and the section on the artery-first approach; Ramia JM wrote the section on arterial complications during pancreatoduodenectomy; Morales R wrote the section on extended lymphadenectomy for pancreatic head adenocarcinoma. AbstractPancreaticoduodenectomy (PD) is the standard surgical treatment for tumors of the pancreatic head, proximal bile duct, duodenum and ampulla, and represents the only hope of cure in cases of malignancy. Since its initial description in 1935 by Whipple et al , this complex surgical technique has evolved and undergone several modifications. We review three key issues in PD: (1) the initial approach to the superior mesenteric artery, known as the artery-first approach; (2) arterial complications caused by anatomic variants of the hepatic artery or celiac artery stenosis; and (3) the extent of lymphadenectomy.

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Pancreatoduodenectomy using a no-touch isolation technique

Cited by 68 publications

References 16 publications

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Laparoscopy-Assisted Distal Pancreatectomy

Tricks and tips in pancreatoduodenectomy

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