Pancreatic resection for cancer—the Heidelberg technique

  • Martin Schneider
  • Oliver Strobel
  • Thilo Hackert
  • Markus W. BüchlerEmail author
How-I-Do-It article



Pancreatic cancer is associated with high recurrence rates, and any surgery should aim to prevent local recurrence. However, systematic resection of putatively tumor-infiltrated soft tissue adjacent to the celiac branches and superior mesenteric artery has not regularly been applied in pancreatic head resection.


We describe a technique of vessel-oriented pancreatic head resection, allowing for extended removal of lymphatic and neural tissue that is situated in the TRIANGLE in between the celiac trunk, the superior mesenteric artery, and the portal vein.


Vessel-oriented dissection or vascular resection facilitates complete removal of putatively tumor-infiltrated soft tissue, thus potentially reducing the risk of isolated local recurrence in pancreatic cancer.


Pancreatic cancer PDAC Pancreatoduodenectomy Artery first TRIANGLE Local recurrence 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Martin Schneider
    • 1
  • Oliver Strobel
    • 1
  • Thilo Hackert
    • 1
  • Markus W. Büchler
    • 1
    Email author
  1. 1.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

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