%0 Journal Article
%T Surgical approaches to the superior mesenteric artery during minimally invasive pancreaticoduodenectomy: A systematic review.
%A Nagakawa Y
%A Watanabe Y
%A Kozono S
%A Boggi U
%A Palanivelu C
%A Liu R
%A Wang SE
%A He J
%A Nishino H
%A Ohtsuka T
%A Ban D
%A Nakata K
%A Endo I
%A Tsuchida A
%A Nakamura M
%A  
%J J Hepatobiliary Pancreat Sci
%V 0
%N 0
%D Feb 2021 1
%M 33523604
%F 3.149
%R 10.1002/jhbp.905
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.