{Reference Type}: Journal Article
{Title}: Surgical approaches to the superior mesenteric artery during minimally invasive pancreaticoduodenectomy: A systematic review.
{Author}: Nagakawa Y;Watanabe Y;Kozono S;Boggi U;Palanivelu C;Liu R;Wang SE;He J;Nishino H;Ohtsuka T;Ban D;Nakata K;Endo I;Tsuchida A;Nakamura M; ;
{Journal}: J Hepatobiliary Pancreat Sci
{Volume}: 0
{Issue}: 0
{Year}: Feb 2021 1
{Factor}: 3.149
{DOI}: 10.1002/jhbp.905
{Abstract}: <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.