Pancreaticoduodenectomy with mesenterico-portal vein resection (with video)

Abstract:
Radical (R0 resection) pancreaticoduodenectomy (PD) is the only treatment offering ahope of long-term survival for patients affected from pancreatic head cancer and malig-nant periampullary tumors. A fine dissection of the retroperitoneal margin close to thesuperior mesenteric artery (SMA) with en bloc retroperitoneal pancreatic tissue ablationis crucial to increase the number of R0 resection and to extend the circumferentialmargin. In the presence of a venous invasion, the total dissection of the SMA allows toperform an easier resection/reconstruction of the mesenterico-portal confluence with ashort clamping time.