Advertisement

Pancreatoduodenectomy: Total Mesopancreas Excision Approach

  • Xu-An Wang
  • Ying-bin Liu
Chapter

Abstract

In 2012, Adham et al. [1] firstly described the application of Total Mesopancreas Excision (TMpE) Approach (Figs. 1.1 and 1.2), for the carcinoma of head of pancreas, which was based on the concept of total mesorectal excision [2]. They defined the contents in the region for the excision to be formed by the superior mesenteric vein, portal vein, superior mesenteric artery, and celiac trunk of the aorta, and they called this region as the “mesopancreas triangle.” Totally 52 patients using the posterior approach of total mesopancreas excision (TMpE) for pancreatic head cancer were reported by them with a very high R0 resection rate of 80.7%, and the 5-year survival rate was significantly improved [1].

References

  1. 1.
    Adham M, Singhirunnusorn J. Surgical technique and results of total mesopancreas excision (TMpE) in pancreatic tumors. Eur J Surg Oncol. 2012;38:340–5.CrossRefGoogle Scholar
  2. 2.
    Gockel I, Domeyer M, Wolloscheck T, et al. Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space. World J Surg Oncol. 2007;5:44.CrossRefGoogle Scholar
  3. 3.
    Liu YB, Quan ZW, Peng SY. The idea and controversy of total mesopancreas excision (TMpE) in pancreatic head tumors. Zhongguo Shi Yong Wai Ke Za Zhi (in Chinese). 2013;33:856–8.Google Scholar
  4. 4.
    Wu WG, Wu XS, Li ML, et al. Total mesopancreas excision (TMpE) for pancreatic head tumors with 75 cases report. Zhongguo Shi Yong Wai Ke Za Zhi (in Chinese). 2013;33:859–62.Google Scholar
  5. 5.
    Wu W, Wang X, Wu X, Li M, Weng H, Cao Y, Bao R, Su S, Lu J, Gong W, Shi W, Gu J, Wang X, Liu Y, Quan Z, Peng S. Total mesopancreas excision for pancreatic head cancer: analysis of 120 cases. Chin J Cancer Res. 2016;28(4):423–8.CrossRefGoogle Scholar
  6. 6.
    Weitz J, Rahbari N, Koch M, Büchler MW. The “artery first” approach for resection of pancreatic head cancer. J Am Coll Surg. 2010;210(2):e1–4.CrossRefGoogle Scholar
  7. 7.
    Jamieson NB, Foulis AK, Oien KA, et al. Positive mobilization margins alone do not influence survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Surg. 2010;251:1003–10.CrossRefGoogle Scholar
  8. 8.
    Zhang Y, Frampton AE, Cohen P, et al. Tumor infiltration in the medial resection margin predicts survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Gastrointest Surg. 2012;16:1875–82.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Xu-An Wang
    • 1
  • Ying-bin Liu
    • 1
  1. 1.Xinhua Hospital, Shanghai Jiaotong UniversityShanghaiChina

Personalised recommendations