The patients will be divided into 2 groups
conventional group: The patients who included this group will undergo conventional pancreaticoduodenectomy (PD) or pylorus preserving pancreaticoduodenectomy (PPPD). We will identify and isolate superior mesenteric vein (SMV) before pancreatic resection. The surgeon will dissect tissue around superior mesenteric artery (SMA) and uncinate process of pancreas along the SMA.
Experimental group:
The patients who included this group will undergo PD or PPPD including total pancreatic mesopancreas excision and superior mesenteric artery approach. Before pancreatic transection, the surgeon will isolate superior mesenteric vein (SMV) and superior mesenteric artery (SMA). And the surgeon will dissect nerve plexus and lymph node around SMA. inferior pancreaticoduodenal artery (IPDA) and first jejunal artery will be identified and the surgeon will ligate according to surgical margin. Anastomosis will be performed as usual manners.
Postoperative manage is same in two groups. The investigators will compared 2 years recurrence free survival rate between conventional and experimental groups.
Age
20–any
Sex
ALL
Healthy volunteers
Accepted
You may be eligible if
Resectable pancreatic head cancer
No systemic metastasis
Age \> 20 years
The patients who understand informed consent and is able to agree with study
You may not be if
The patients who have systemic metastasis
The patients who need neoadjuvant therapy in borderline resectable and locally advanced pancreatic cancer
Those with active or uncontrolled infections
Those with severe psychiatric / neurological disorders
Alcohol or other drug addicts
Patients with moderate or severe comorbidities who are thought to have an impact on quality of life or nutritional status (cirrhosis, chronic kidney failure, heart failure, etc.)
Clareo Health | Usefulness of the Artery First Approach in Pancreatic Cancer Surgery
