Comparison of access to the superior mesenteric arteryduring the execution of the pancreatoduodenal resectionin patients with borderline-resectable cancer of the pancreatic head

Abstract

The purpose of the study is to study the technical aspects of surgical treatment of borderline-resectable pancreatic head tumors Materials and methods. An analysis of the implementation of the DA was performed in 102 patients with borderline-resectable pancreatic head cancer. In 20% of patients, the tumor grows in the region of the celiac-mesenteric gap of the tumor (mesopancreas germination). In 25.6%, the tumor grows on the wall of the portal-superior mesenteric segment. In 12.7%, the tumor tightly covers the walls of the branches of the celiac trunk or superior mesenteric artery by less than 180 degrees, extending to the fascial sheath and adventitia of the vessel. Results. During the implementation of the DA with various methods of access to the IWL, no significant differences were revealed in the early postoperative period. Conclusion. The choice of access is determined by the “anatomy” of the spread of the tumor. AMS rear access is most convenient for IPDA isolation and ligation. Mesenteric access allows the most secure ligation of PDJV