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Surgery for Pancreatic and Periampullary Carcinoma

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Abstract

Surgical resection for pancreatic and periampullary cancer has evolved over several decades. The postoperative mortality for these resections has declined to less than 5 %. However, morbidity associated with these resections is still considerable. Various technical modifications like pylorus preservation, reconstruction techniques and methods to perform pancreaticoenteric anastomosis have been suggested to improve postoperative outcomes after pancreaticoduodenectomy. Surgical modifications to improve oncological clearance and decrease fistula rates after distal pancreatic resections have also been suggested. Dilemma still exists whether interventions like pancreatic duct stents, octreotide and drains help to improve postoperative outcomes. The role of extended lymph node dissection and extended resections for pancreatic and periampullary cancer is still controversial, as is the management of borderline resectable pancreatic cancer. In this review, we discuss the literature pertaining to various surgical aspects of pancreatic and periampullary carcinoma.

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References

  1. McPhee JT, Hill JS, Whalen GF, Zayaruzny M, Litwin DE, Sullivan ME, Anderson FA, Tseng JF (2007) Perioperative mortality for pancreatectomy: a national perspective. Ann Surg 246:246–253

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bassi C, Falconi M, Salvia R, Mascetta G, Molinari E, Pederzoli P (2001) Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg 18:453–457

    Article  PubMed  CAS  Google Scholar 

  3. Vin Y, Sima CS, Getrajdman GI, Brown KT, Covey A, Brennan MF, Allen PJ (2008) Management and outcomes of postpancreatectomy fistula, leak, and abscess: results of 908 patients resected at a single institution between 2000 and 2005. J Am Coll Surg 207:490–498

    Article  PubMed  Google Scholar 

  4. Cameron JL, Riall TS, Coleman J, Belcher KA (2006) One thousand consecutive pancreaticoduodenectomies. Ann Surg 244:10–15

    Article  PubMed  PubMed Central  Google Scholar 

  5. Whipple AO, Parsons WB, Mullins CR (1935) Treatment of carcinoma of the ampulla of vater. Ann Surg 102:763–779

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Traverso LW, Longmire WP Jr (1980) Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation. Ann Surg 192:306–310

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Wenger FA, Jacobi CA, Haubold K, Zieren HU, Müller JM (1999) Gastrointestinal quality of life after duodenopancreatectomy in pancreatic carcinoma. Preliminary results of a prospective randomized study: pancreatoduodenectomy or pylorus-preserving pancreatoduodenectomy. Chirurg 70:1454–1459

    Article  PubMed  CAS  Google Scholar 

  8. Williamson RC, Bliouras N, Cooper MJ, Davies ER (1993) Gastric emptying and enterogastric reflux after conservative and conventional pancreatoduodenectomy. Surgery 114:82–86

    PubMed  CAS  Google Scholar 

  9. Park YC, Kim SW, Jang JY, Ahn YJ, Park YH (2003) Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy. J Am Coll Surg 196:859–865

    Article  PubMed  Google Scholar 

  10. Diener MK, Fitzmaurice C, Schwarzer G, Seiler CM, Hüttner FJ, Antes G, Knaebel HP, Büchler MW (2014) Pylorus-preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment of periampullary and pancreatic carcinoma. Cochrane Database Syst Rev 11, CD006053

    PubMed  PubMed Central  Google Scholar 

  11. Kawai M, Tani M, Hirono S, Okada K, Miyazawa M, Yamaue H (2014) Pylorus-resecting pancreaticoduodenectomy offers long-term outcomes similar to those of pylorus-preserving pancreaticoduodenectomy: results of a prospective study. World J Surg 38:1476–1483

    Article  PubMed  Google Scholar 

  12. Kawai M, Tani M, Hirono S, Miyazawa M, Shimizu A, Uchiyama K, Yamaue H (2011) Pylorus ring resection reduces delayed gastric emptying in patients undergoing pancreatoduodenectomy: a prospective, randomized, controlled trial of pylorus-resecting versus pylorus-preserving pancreatoduodenectomy. Ann Surg 253:495–501

    Article  PubMed  Google Scholar 

  13. Yang C, Wu HS, Chen XL, Wang CY, Gou SM, Xiao J, He ZQ, Chen QJ, Li YF (2014) Pylorus-preserving versus pylorus-resecting pancreaticoduodenectomy for periampullary and pancreatic carcinoma: a meta-analysis. PLoS One 9, e90316

    Article  PubMed  PubMed Central  Google Scholar 

  14. Shrikhande SV, Kleeff J, Büchler MW, Friess H (2007) Pancreatic anastomosis after pancreaticoduodenectomy: how we do it. Indian J Surg 69:224–229

    Article  PubMed  PubMed Central  Google Scholar 

  15. Berger AC, Howard TJ, Kennedy EP, Sauter PK, Bower-Cherry M, Dutkevitch S, Hyslop T, Schmidt CM, Rosato EL, Lavu H, Nakeeb A, Pitt HA, Lillemoe KD, Yeo CJ (2009) Does type of pancreaticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg 208:738–747

    Article  PubMed  Google Scholar 

  16. Peng S, Mou Y, Cai X, Peng C (2002) Binding pancreaticojejunostomy is a new technique to minimize leakage. Am J Surg 183:283–285

    Article  PubMed  Google Scholar 

  17. Peng SY, Wang JW, Lau WY, Cai XJ, Mou YP, Liu YB, Li JT (2007) Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg 245:692–698

    Article  PubMed  PubMed Central  Google Scholar 

  18. Maggiori L, Sauvanet A, Nagarajan G, Dokmak S, Aussilhou B, Belghiti J (2010) Binding versus conventional pancreaticojejunostomy after pancreaticoduodenectomy: a case-matched study. J Gastrointest Surg 14:1395–1400

    Article  PubMed  Google Scholar 

  19. Casadei R, Ricci C, Silvestri S, Campra D, Ercolani G, D’Ambra M, Pinna AD, Fronda GR, Minni F (2013) Peng’s binding pancreaticojejunostomy after pancreaticoduodenectomy. An Italian, prospective, dual institution study. Pancreatology 13:305–309

    Article  PubMed  Google Scholar 

  20. Li X, Dong M, Sheng W, Yue L, Liu Q, Dong Q (2014) A meta-analysis of pancreaticojejunostomy on pancreatic fistula after pancreaticoduodenectomy. Zhonghua Wai Ke Za Zhi 52:662–667

    PubMed  Google Scholar 

  21. Shrikhande SV, Qureshi SS, Rajneesh N, Shukla PJ (2005) Pancreatic anastomoses after pancreaticoduodenectomy: do we need further studies? World J Surg 29:1642–1649

    Article  PubMed  Google Scholar 

  22. Shrikhande SV, Barreto G, Shukla PJ (2008) Pancreatic fistula after pancreaticoduodenectomy: the impact of a standardized technique of pancreaticojejunostomy. Langenbecks Arch Surg 393:87–91

    Article  PubMed  Google Scholar 

  23. Waugh JM, Clagett OT (1946) Resection of the duodenum and head of the pancreas for carcinoma; an analysis of thirty cases. Surgery 20:224–232

    PubMed  CAS  Google Scholar 

  24. Ohigashi H, Ishikawa O, Eguchi H, Sasaki Y, Yamada T, Kishi K, Noura S, Takachi K, Miyashiro I, Oue M, Yano M, Imaoka S (2008) A simple and safe anastomosis in pancreaticogastrostomy using mattress sutures. Am J Surg 196:130–134

    Article  PubMed  Google Scholar 

  25. Takao S, Shinchi H (2012) Pancreaticogastrostomy: a pancreas-transfixing method with duct-to-mucosa anastomosis (with video). J Hepatobiliary Pancreat Sci 19:131–134

    Article  PubMed  PubMed Central  Google Scholar 

  26. Osman MM, Abd El Maksoud W (2014) Evaluation of a new modification of pancreaticogastrostomy after pancreaticoduodenectomy: anastomosis of the pancreatic duct to the gastric mucosa with invagination of the pancreatic remnant end into the posterior gastric wall for patients with cancer head of pancreas and periampullary carcinoma in terms of postoperative pancreatic fistula formation. Int J Surg Oncol 2014:490386

    PubMed  Google Scholar 

  27. Peng SY, An WX, Liu Y, Hong D, Li J, Tao F, Tan Z (2009) Peng’s pancreaticogastrostomy—comparative study on types I and II procedures (with types III and IV appended). J Surg Concepts Prac 14:5

    Google Scholar 

  28. Bartsch DK, Langer P, Kanngießer V, Fendrich V, Dietzel K (2012) A simple and safe anastomosis for pancreatogastrostomy using one binding purse-string and two transfixing mattress sutures. Int J Surg Oncol 2012:718637

    PubMed  CAS  PubMed Central  Google Scholar 

  29. Zhu F, Wang M, Wang X, Tian R, Shi C, Xu M, Shen M, Han J, Luo N, Qin R (2013) Modified technique of pancreaticogastrostomy for soft pancreas with two continuous hemstitch sutures: a single-center prospective study. J Gastrointest Surg 17:1306–1311

    Article  PubMed  PubMed Central  Google Scholar 

  30. Fernández-Cruz L, Cosa R, Blanco L, López-Boado MA, Astudillo E (2008) Pancreatogastrostomy with gastric partition after pylorus-preserving pancreatoduodenectomy versus conventional pancreatojejunostomy: a prospective randomized study. Ann Surg 248:930–938

    Article  PubMed  Google Scholar 

  31. Bassi C, Falconi M, Molinari E, Salvia R, Butturini G, Sartori N, Mantovani W, Pederzoli P (2005) Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. Ann Surg 242:767–771

    Article  PubMed  PubMed Central  Google Scholar 

  32. Duffas JP, Suc B, Msika S, Fourtanier G, Muscari F, Hay JM, Fingerhut A, Millat B, Radovanowic A, Fagniez PL, French Associations for Research in Surgery (2005) A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy. Am J Surg 189:720–729

    Article  PubMed  Google Scholar 

  33. Topal B, Fieuws S, Aerts R, Weerts J, Feryn T, Roeyen G, Bertrand C, Hubert C, Janssens M, Closset J, Belgian Section of Hepatobiliary and Pancreatic Surgery (2013) Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol 14:655–662

    Article  PubMed  Google Scholar 

  34. Wente MN, Shrikhande SV, Müller MW, Diener MK, Seiler CM, Friess H, Büchler MW (2007) Pancreaticojejunostomy versus pancreaticogastrostomy: systematic review and meta-analysis. Am J Surg 193:171–183

    Article  PubMed  Google Scholar 

  35. Menahem B, Guittet L, Mulliri A, Alves A, Lubrano J (2015) Pancreaticogastrostomy is superior to pancreaticojejunostomy for prevention of pancreatic fistula after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials. Ann Surg 261:882–887

    Article  PubMed  Google Scholar 

  36. Hallet J, Zih FS, Deobald RG, Scheer AS, Law CH, Coburn NG, Karanicolas PJ (2015) The impact of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction on pancreatic fistula after pancreaticoduodenectomy: meta-analysis of randomized controlled trials. HPB (Oxford) 17:113–122

    Article  Google Scholar 

  37. Machado MC, da Cunha JE, Bacchella T, Bove P (1976) A modified technique for the reconstruction of the alimentary tract after pancreatoduodenectomy. Surg Gynecol Obstet 143:271–272

    PubMed  CAS  Google Scholar 

  38. Khan AW, Agarwal AK, Davidson BR (2002) Isolated Roux Loop duct-to-mucosa pancreaticojejunostomy avoids pancreatic leaks in pancreaticoduodenectomy. Dig Surg 19:199–204

    Article  PubMed  Google Scholar 

  39. Sutton CD, Garcea G, White SA, O’Leary E, Marshall LJ, Berry DP, Dennison AR (2004) Isolated Roux-loop pancreaticojejunostomy: a series of 61 patients with zero postoperative pancreaticoenteric leaks. J Gastrointest Surg 8:701–705

    Article  PubMed  Google Scholar 

  40. Klaiber U, Probst P, Knebel P, Contin P, Diener MK, Büchler MW, Hackert T (2015) Meta-analysis of complication rates for single-loop versus dual-loop (Roux-en-Y) with isolated pancreaticojejunostomy reconstruction after pancreaticoduodenectomy. Br J Surg 102:331–340

    Article  PubMed  CAS  Google Scholar 

  41. Dong Z, Xu J, Wang Z, Petrov MS (2013) Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy. Cochrane Database Syst Rev 6, CD008914

    PubMed  Google Scholar 

  42. Winter JM, Cameron JL, Campbell KA, Chang DC, Riall TS, Schulick RD et al (2006) Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 10:1280–1290

    Article  PubMed  Google Scholar 

  43. Pessaux P, Sauvanet A, Mariette C, Paye F, Muscari F, Cunha A et al (2011) External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial. Ann Surg 253:879–885

    Article  PubMed  Google Scholar 

  44. Poon RT, Fan ST, Lo CM, Ng KK, Yuen WK, Yeung C et al (2007) External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg 246:425–435

    Article  PubMed  PubMed Central  Google Scholar 

  45. Motoi F, Egawa S, Rikiyama T, Katayose Y, Unno M (2012) Randomized clinical trial of external stent drainage of the pancreatic duct to reduce postoperative pancreatic fistula after pancreaticojejunostomy. Br J Surg 99:524–531

    Article  PubMed  CAS  Google Scholar 

  46. Wang G, Sun B, Jiang H, Li L, Ma Y, Wu L, Liu J, Li P, Wu X (2014) A prospective randomized controlled trial of pancreatic duct stent internal versus external drainage with pancreaticojejunostomy for the early curative effect after pancreaticoduodenectomy. Zhonghua Wai Ke Za Zhi 52:333–337

    PubMed  Google Scholar 

  47. Büchler M, Friess H, Klempa I, Hermanek P, Sulkowski U, Becker H, Schafmayer A, Baca I, Lorenz D, Meister R et al (1992) Role of octreotide in the prevention of postoperative complications following pancreatic resection. Am J Surg 163:125–130

    Article  PubMed  Google Scholar 

  48. Pederzoli P, Bassi C, Falconi M, Camboni MG (1994) Efficacy of octreotide in the prevention of complications of elective pancreatic surgery. Italian Study Group. Br J Surg 81:265–269

    Article  PubMed  CAS  Google Scholar 

  49. Montorsi M, Zago M, Mosca F, Capussotti L, Zotti E, Ribotta G, Fegiz G, Fissi S, Roviaro G, Peracchia A et al (1995) Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized clinical trial. Surgery 117:26–31

    Article  PubMed  CAS  Google Scholar 

  50. Friess H, Beger HG, Sulkowski U, Becker H, Hofbauer B, Dennler HJ, Büchler MW (1995) Randomized controlled multicentre study of the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis. Br J Surg 82:1270–1273

    Article  PubMed  CAS  Google Scholar 

  51. Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, Campbell KA, Choti MA (2000) Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg 232:419–429

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  52. Gouillat C, Chipponi J, Baulieux J, Partensky C, Saric J, Gayet B (2001) Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy. Br J Surg 88:1456–1462

    Article  PubMed  CAS  Google Scholar 

  53. Kollmar O, Moussavian MR, Richter S, de Roi P, Maurer CA, Schilling MK (2008) Prophylactic octreotide and delayed gastric emptying after pancreaticoduodenectomy: results of a prospective randomized double-blinded placebo-controlled trial. Eur J Surg Oncol 34:868–875

    Article  PubMed  CAS  Google Scholar 

  54. Gurusamy KS, Koti R, Fusai G, Davidson BR (2010) Somatostatin analogues for pancreatic surgery. Cochrane Database Syst Rev 2, CD008370

    PubMed  Google Scholar 

  55. Mutter D, Panis Y, Escat J (1999) Drainage in digestive surgery. French Society of Digestive Surgery. J Chir (Paris) 136:117–123

    CAS  Google Scholar 

  56. Conlon KC, Labow D, Leung D, Smith A, Jarnagin W, Coit DG, Merchant N, Brennan MF (2001) Prospective randomized clinical trial of the value of intraperitoneal drainage after pancreatic resection. Ann Surg 234:487–493

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  57. Van Buren G, Bloomston M, Hughes SJ, Winter J, Behrman SW, Zyromski NJ, Vollmer C, Velanovich V, Riall T, Muscarella P, Trevino J, Nakeeb A, Schmidt CM, Behrns K, Ellison EC, Barakat O, Perry KA, Drebin J, House M, Abdel-Misih S, Silberfein EJ, Goldin S, Brown K, Mohammed S, Hodges SE, McElhany A, Issazadeh M, Jo E, Mo Q, Fisher WE (2014) A randomized prospective multicenter trial of pancreaticoduodenectomy with and without routine intraperitoneal drainage. Ann Surg 259:605–612

    Article  PubMed  Google Scholar 

  58. Dou CW, Liu ZK, Jia YL, Zheng X, Tu KS, Yao YM, Liu QG (2015) Systematic review and meta-analysis of prophylactic abdominal drainage after pancreatic resection. World J Gastroenterol 21:5719–5734

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lim C, Dokmak S, Cauchy F, Aussilhou B, Belghiti J, Sauvanet A (2013) Selective policy of no drain after pancreaticoduodenectomy is a valid option in patients at low risk of pancreatic fistula: a case–control analysis. World J Surg 37:1021–1027

    Article  PubMed  Google Scholar 

  60. Kawai M, Tani M, Terasawa H, Ina S, Hirono S, Nishioka R, Miyazawa M, Uchiyama K, Yamaue H (2006) Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for 104 consecutive patients. Ann Surg 244:1–7

    Article  PubMed  PubMed Central  Google Scholar 

  61. Zink SI, Soloff EV, White RR, Clary BM, Tyler DS, Pappas TN, Paulson EK (2009) Pancreaticoduodenectomy: frequency and outcome of post-operative imaging-guided percutaneous drainage. Abdom Imaging 34:767–771

    Article  PubMed  Google Scholar 

  62. Shrikhande SV, Barreto SG, Shetty G, Suradkar K, Bodhankar YD, Shah SB, Goel M (2013) Post-operative abdominal drainage following major upper gastrointestinal surgery: single drain versus two drains. J Cancer Res Ther 9:267–271

    Article  PubMed  Google Scholar 

  63. Pai E, Shrikhande SV (2014) Drainage after pancreaticoduodenectomy: to step back may be the way forward, but are randomized controlled trials making us any wiser? Ann Surg

  64. Strasberg SM, Linehan DC, Hawkins WG (2007) Radical antegrade modular pancreatosplenectomy procedure for adenocarcinoma of the body and tail of the pancreas: ability to obtain negative tangential margins. J Am Coll Surg 204:244–249

    Article  PubMed  Google Scholar 

  65. Strasberg SM, Drebin JA, Linehan D (2003) Radical antegrade modular pancreatosplenectomy. Surgery 133:521–527

    Article  PubMed  Google Scholar 

  66. Mitchem JB, Hamilton N, Gao F, Hawkins WG, Linehan DC, Strasberg SM (2012) Long-term results of resection of adenocarcinoma of the body and tail of the pancreas using radical antegrade modular pancreatosplenectomy procedure. J Am Coll Surg 214:46–52

    Article  PubMed  Google Scholar 

  67. Christein JD, Kendrick ML, Iqbal CW, Nagorney DM, Farnell MB (2005) Distal pancreatectomy for resectable adenocarcinoma of the body and tail of the pancreas. J Gastrointest Surg 9:922–927

    Article  PubMed  Google Scholar 

  68. Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC 3rd, Kim HJ, Ahmad S, Cho CS, Parikh AA, Chu CK, Hamilton NA, Doyle CJ, Pinchot S, Hayman A, McClaine R, Nakeeb A, Staley CA, McMasters KM, Lillemoe KD (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210:779–785

    Article  PubMed  Google Scholar 

  69. Yamamoto J, Saiura A, Koga R, Seki M, Katori M, Kato Y, Sakamoto Y, Kokudo N, Yamaguchi T (2010) Improved survival of left-sided pancreas cancer after surgery. Jpn J Clin Oncol 40:530–536

    Article  PubMed  Google Scholar 

  70. Kang CM, Kim DH, Lee WJ (2010) Ten years of experience with resection of left-sided pancreatic ductal adenocarcinoma: evolution and initial experience to a laparoscopic approach. Surg Endosc 24:1533–1541

    Article  PubMed  Google Scholar 

  71. Ferrone CR, Warshaw AL, Rattner DW, Berger D, Zheng H, Rawal B, Rodriguez R, Thayer SP, Fernandez-del Castillo C (2008) Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg 12:1691–1697

    Article  PubMed  PubMed Central  Google Scholar 

  72. Nathan H, Cameron JL, Goodwin CR, Seth AK, Edil BH, Wolfgang CL, Pawlik TM, Schulick RD, Choti MA (2009) Risk factors for pancreatic leak after distal pancreatectomy. Ann Surg 250:277–281

    Article  PubMed  Google Scholar 

  73. Diener MK, Seiler CM, Rossion I, Kleeff J, Glanemann M, Butturini G, Tomazic A, Bruns CJ, Busch OR, Farkas S, Belyaev O, Neoptolemos JP, Halloran C, Keck T, Niedergethmann M, Gellert K, Witzigmann H, Kollmar O, Langer P, Steger U, Neudecker J, Berrevoet F, Ganzera S, Heiss MM, Luntz SP, Bruckner T, Kieser M, Büchler MW (2011) Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet 377:1514–1522

    Article  PubMed  Google Scholar 

  74. Zhang H, Zhu F, Shen M, Tian R, Shi CJ, Wang X, Jiang JX, Hu J, Wang M, Qin RY (2015) Systematic review and meta-analysis comparing three techniques for pancreatic remnant closure following distal pancreatectomy. Br J Surg 102:4–15

    Article  PubMed  CAS  Google Scholar 

  75. Frozanpor F, Lundell L, Segersvärd R, Arnelo U (2012) The effect of prophylactic transpapillary pancreatic stent insertion on clinically significant leak rate following distal pancreatectomy: results of a prospective controlled clinical trial. Ann Surg 255:1032–1036

    Article  PubMed  Google Scholar 

  76. Hamilton NA, Porembka MR, Johnston FM, Gao F, Strasberg SM, Linehan DC, Hawkins WG (2012) Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy: a single-blinded, randomized controlled trial. Ann Surg 255:1037–1042

    Article  PubMed  PubMed Central  Google Scholar 

  77. Pedrazzoli S, DiCarlo V, Dionigi R, Mosca F, Pederzoli P, Pasquali C, Klöppel G, Dhaene K, Michelassi F (1998) Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg 228:508–517

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  78. Riall TS, Cameron JL, Lillemoe KD, Campbell KA, Sauter PK, Coleman J, Abrams RA, Laheru D, Hruban RH, Yeo CJ (2005) Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma—part 3: update on 5-year survival. J Gastrointest Surg 9:1191–1204

    Article  PubMed  Google Scholar 

  79. Farnell MB, Pearson RK, Sarr MG, DiMagno EP, Burgart LJ, Dahl TR et al (2005) A prospective randomized trial comparing standard pancreatoduodenectomy with pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head adenocarcinoma. Surgery 138:618–630

    Article  PubMed  Google Scholar 

  80. Nimura Y, Nagino M, Takao S, Takada T, Miyazaki K, Kawarada Y, Miyagawa S, Yamaguchi A, Ishiyama S, Takeda Y, Sakoda K, Kinoshita T, Yasui K, Shimada H, Katoh H (2012) Standard versus extended lymphadenectomy in radical pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas: long-term results of a Japanese multicenter randomized controlled trial. J Hepatobiliary Pancreat Sci 19:230–241

    Article  PubMed  Google Scholar 

  81. Tol JA, Gouma DJ, Bassi C, Dervenis C, Montorsi M, Adham M, Andrén-Sandberg A, Asbun HJ, Bockhorn M, Büchler MW, Conlon KC, Fernández-Cruz L, Fingerhut A, Friess H, Hartwig W, Izbicki JR, Lillemoe KD, Milicevic MN, Neoptolemos JP, Shrikhande SV, Vollmer CM, Yeo CJ, Charnley RM, International Study Group on Pancreatic Surgery (2014) Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS). Surgery 156:591–600

    Article  PubMed  Google Scholar 

  82. Murakami Y, Uemura K, Sudo T, Hashimoto Y, Yuasa Y, Sueda T (2010) Prognostic impact of para-aortic lymph node metastasis in pancreatic ductal adenocarcinoma. World J Surg 34:1900–1907

    Article  PubMed  Google Scholar 

  83. Shrikhande SV, Kleeff J, Reiser C, Weitz J, Hinz U, Esposito I, Schmidt J, Friess H, Büchler MW (2007) Pancreatic resection for M1 pancreatic ductal adenocarcinoma. Ann Surg Oncol 14:118–127

    Article  PubMed  Google Scholar 

  84. Yamada S, Nakao A, Fujii T, Sugimoto H, Kanazumi N, Nomoto S, Kodera Y, Takeda S (2009) Pancreatic cancer with paraaortic lymph node metastasis: a contraindication for radical surgery? Pancreas 38:e13–e17

    Article  PubMed  Google Scholar 

  85. Hartwig W, Hackert T, Hinz U, Hassenpflug M, Strobel O, B€uchler MW et al (2009) Multivisceral resection for pancreatic malignancies: risk-analysis and long-term outcome. Ann Surg 250:81–87

    Article  PubMed  Google Scholar 

  86. Burdelski CM, Reeh M, Bogoevski D, Gebauer F, Tachezy M, Vashist YK et al (2011) Multivisceral resections in pancreatic cancer: identification of risk factors. World J Surg 35:2756–2763

    Article  PubMed  Google Scholar 

  87. Suzuki Y, Fujino Y, Tanioka Y, Sakai T, Ajiki T, Ueda T et al (2004) Resection of the colon simultaneously with pancreaticoduodenectomy for tumors of the pancreas and periampullary region: short-term and long-term results. World J Surg 28:1007–1010

    Article  PubMed  Google Scholar 

  88. Hartwig W, Vollmer CM, Fingerhut A, Yeo CJ, Neoptolemos JP, Adham M, Andrén-Sandberg A, Asbun HJ, Bassi C, Bockhorn M, Charnley R, Conlon KC, Dervenis C, Fernandez-Cruz L, Friess H, Gouma DJ, Imrie CW, Lillemoe KD, Milićević MN, Montorsi M, Shrikhande SV, Vashist YK, Izbicki JR, Büchler MW, International Study Group on Pancreatic Surgery (2014) Extended pancreatectomy in pancreatic ductal adenocarcinoma: definition and consensus of the International Study Group for Pancreatic Surgery (ISGPS). Surgery 156:1–14

    Article  PubMed  Google Scholar 

  89. Takahashi S, Kinoshita T, Konishi M, Gotohda N, Kato Y, Kinoshita T, Kobayashi T, Mitsunaga S, Nakachi K, Ikeda M (2011) Borderline resectable pancreatic cancer: rationale for multidisciplinary treatment. J Hepatobiliary Pancreat Sci 18:567–574

    Article  PubMed  Google Scholar 

  90. Shrikhande SV, Arya S, Barreto SG, Ingle S, D’Souza MA, Hawaldar R, Shukla PJ (2011) Borderline resectable pancreatic tumors: is there a need for further refinement of this stage? Hepatobiliary Pancreat Dis Int 10:319–324

    Article  PubMed  Google Scholar 

  91. Siriwardana HP, Siriwardena AK (2006) Systematic review of outcome of synchronous portal-superior mesenteric vein resection during pancreatectomy for cancer. Br J Surg 93:662–673

    Article  PubMed  CAS  Google Scholar 

  92. Zhou Y, Zhang Z, Liu Y, Li B, Xu D (2012) Pancreatectomy combined with superior mesenteric vein-portal vein resection for pancreatic cancer: a meta-analysis. World J Surg 36:884–891

    Article  PubMed  Google Scholar 

  93. Bockhorn M, Uzunoglu FG, Adham M, Imrie C, Milicevic M, Sandberg AA, Asbun HJ, Bassi C, Büchler M, Charnley RM, Conlon K, Cruz LF, Dervenis C, Fingerhutt A, Friess H, Gouma DJ, Hartwig W, Lillemoe KD, Montorsi M, Neoptolemos JP, Shrikhande SV, Takaori K, Traverso W, Vashist YK, Vollmer C, Yeo CJ, Izbicki JR, International Study Group of Pancreatic Surgery (2014) Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 155:977–988

    Article  PubMed  Google Scholar 

  94. Mollberg N, Rahbari NN, Koch M, Hartwig W, Hoeger Y, Büchler MW, Weitz J (2011) Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg 254:882–893

    Article  PubMed  Google Scholar 

  95. Sanjay P, Takaori K, Govil S, Shrikhande SV, Windsor JA (2012) ‘Artery first’ approaches to pancreatoduodenectomy. Br J Surg 99:1027–1035

    Article  PubMed  CAS  Google Scholar 

  96. Shrikhande SV, Barreto SG, Bodhankar YD, Suradkar K, Shetty G, Hawaldar R, Goel M, Shukla PJ (2011) Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes. Langenbecks Arch Surg 396:1205–1212

    Article  PubMed  Google Scholar 

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Correspondence to Shailesh V. Shrikhande.

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Mitra, A., D’Souza, A., Goel, M. et al. Surgery for Pancreatic and Periampullary Carcinoma. Indian J Surg 77, 371–380 (2015). https://doi.org/10.1007/s12262-015-1358-9

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  • DOI: https://doi.org/10.1007/s12262-015-1358-9

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