Hepatobiliary Pancreat Dis Int ; 16 2 :Apr. Increasing evidence showed that a periadventiceal dissection of the SMA with early transection of the inflow during pancreaticoduodenectomy associates better early perioperative results, and setup the scene for long-term oncological benefits.
The objectives of the current study are to compare the operative results and long-term oncological outcomes of SMA first approach pancreaticoduodenectomy SMA-PD with standard pancreaticoduodenectomy S-PD. The SMA-PD was associated with less intraoperative bleeding, less blood transfusions and higher rate of associated venous resections.
The pancreatic fistula and delayed gastric emptying had a significantly lower rate in the SMA-PD group. There were no differences between the two approaches regarding overall complications, major complication rates and in-hospital peritoneal cancer incidence.
There was no difference regarding R0 resection peritoneal cancer incidence, and one- two- or three-year overall survival. Although the one- two- or three-year overall survival rate is not superior, the SMA-PD has a lower local and peritoneal cancer incidence recurrence rate.
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