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Abstract：
BACKGROUND: Minimally invasive pancreaticoduodenectomy (MIPD) has recently been safely performed by experts, and various methods for resection have been reported. This review summarizes the literature describing surgical approaches for MIPD.
METHODS: A systematic literature search of PubMed (MEDLINE) was conducted for studies reporting robotic and laparoscopic pancreaticoduodenectomy; the reference lists of review articles were searched. Of 444 articles yielded, 23 manuscripts describing the surgical approach to dissect around the superior mesenteric artery (SMA), including hand-searched articles, were assessed.
RESULTS: Various approaches to dissect around the SMA have been reported. These approaches were categorized according to the direction toward the SMA when initiating dissection around the SMA: anterior approach (two articles), posterior approach (four articles), right approach (16 articles), and left approach (three articles). Thus, many reports used the right approach. Most articles provided a technical description. Some articles showed the advantage of their method in a comparison study. However, these were single-center retrospective studies with a small sample size.
CONCLUSIONS: Various approaches for MIPD have been reported; however, few authors have reported the advantage of their methods compared to other methods. Further discussion is needed to clarify the appropriate surgical approach to the SMA during MIPD.
METHODS: A systematic literature search of PubMed (MEDLINE) was conducted for studies reporting robotic and laparoscopic pancreaticoduodenectomy; the reference lists of review articles were searched. Of 444 articles yielded, 23 manuscripts describing the surgical approach to dissect around the superior mesenteric artery (SMA), including hand-searched articles, were assessed.
RESULTS: Various approaches to dissect around the SMA have been reported. These approaches were categorized according to the direction toward the SMA when initiating dissection around the SMA: anterior approach (two articles), posterior approach (four articles), right approach (16 articles), and left approach (three articles). Thus, many reports used the right approach. Most articles provided a technical description. Some articles showed the advantage of their method in a comparison study. However, these were single-center retrospective studies with a small sample size.
CONCLUSIONS: Various approaches for MIPD have been reported; however, few authors have reported the advantage of their methods compared to other methods. Further discussion is needed to clarify the appropriate surgical approach to the SMA during MIPD.
摘要：
背景：专家最近安全地进行了微创胰十二指肠切除术（MIPD），并且已经报道了各种切除方法。这篇综述总结了描述MIPD手术方法的文献。
方法：对PubMed（MEDLINE）进行系统的文献检索，研究报告机器人和腹腔镜胰十二指肠切除术；检索综述文章的参考列表。在发表的444篇文章中，23篇手稿描述了围绕肠系膜上动脉（SMA）解剖的手术方法，包括手工搜索的文章，被评估。
结果：已经报道了各种解剖SMA的方法。当开始在SMA周围解剖时，根据朝向SMA的方向对这些方法进行分类：前路（两篇文章），后路（四篇），正确的方法(16条)，和左法(三篇)。因此，许多报告使用了正确的方法。大多数文章提供了技术描述。一些文章在比较研究中显示了其方法的优势。然而,这些是单中心回顾性研究,样本量较小.
结论：已经报道了MIPD的各种方法；然而，很少有作者报道他们的方法与其他方法相比的优势。需要进一步讨论以阐明MIPD期间SMA的适当手术方法。
方法：对PubMed（MEDLINE）进行系统的文献检索，研究报告机器人和腹腔镜胰十二指肠切除术；检索综述文章的参考列表。在发表的444篇文章中，23篇手稿描述了围绕肠系膜上动脉（SMA）解剖的手术方法，包括手工搜索的文章，被评估。
结果：已经报道了各种解剖SMA的方法。当开始在SMA周围解剖时，根据朝向SMA的方向对这些方法进行分类：前路（两篇文章），后路（四篇），正确的方法(16条)，和左法(三篇)。因此，许多报告使用了正确的方法。大多数文章提供了技术描述。一些文章在比较研究中显示了其方法的优势。然而,这些是单中心回顾性研究,样本量较小.
结论：已经报道了MIPD的各种方法；然而，很少有作者报道他们的方法与其他方法相比的优势。需要进一步讨论以阐明MIPD期间SMA的适当手术方法。
