Uncinate process first-a novel approach for pancreatic head resection

Purpose Partial pancreatico-duodenectomy is the standard treatment for malignancies of the pancreatic head. We describe a technical modification with a retrograde dissection of the pancreatic head as a novel surgical approach. Methods Retrograde resection of the pancreatic head is performed starting with the uncinate process after division of the first jejunal loop and transection of the pancreas as the last operative step of the resection. Technical aspects and possible advantages for this procedure are discussed. Results The retrograde resection can be safely performed and offers a comfortable and innovative approach for pancreatico-duodenectomy. Conclusions The uncinate process first approach can serve as an additional approach in modern pancreatic surgery. Further studies are required to evaluate this procedure regarding operative parameters and postoperative outcome compared to the standard resection.