Journal
JOURNAL OF GASTROINTESTINAL SURGERY
Volume 20, Issue 2, Pages 450-454Publisher
SPRINGER
DOI: 10.1007/s11605-015-3034-6
Keywords
Superior mesenteric artery; Distal pancreatectomy; Pancreatic cancer
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Superior mesenteric artery (SMA)-first approaches are operative tactics used to determine tumor resectability early during pancreatoduodenectomy. With locally advanced carcinoma of the pancreatic body and tail, early determination of SMA involvement also helps establish whether curative resection is feasible. During either radical antegrade modular pancreatosplenectomy (RAMPS) or classic left-to-right distal pancreatectomy, dissection of the SMA is performed after transection of the pancreas or wide detachment of the distal pancreas and spleen. Herein, we describe an inframesocolic SMA-first approach as an introductory procedure when treating carcinoma of the pancreatic body and tail. This first approach procedure provides a reliable and safe introduction to RAMPS.
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