J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 4805KB） [Members Only]

J.Jpn. Surg. Soc.. 120(4): 398-404, 2019

Feature topic

CURRENT TOPICS IN SURGICAL ANATOMY RELATED TO PANCREATODUODENECTOMY

1) Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
2) Department of Clinical Anatomy, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

Daisuke Ban1), Toshitaka Sugawara1), Satoru Muroo2), Keiichi Akita2), Minoru Tanabe1)

In order to perform safe, accurate pancreatoduodenectomy, anatomic knowledge of the pancreas is indispensable. A number of anatomic studies have been performed, and this article summarizes the investigations related to pancreatoduodenectomy as well as reports on some recent topics. Recently, the word “mesopancreas” has been used often, although it is a misnomenclature on an anatomic basis. The area referred to as the mesopancreas is essential to achieve R0 resection in pancreatic head cancer surgery. However, the use of the word mesopancreas is problematic because it is not supported by anatomy. In addition, we outline the anatomy of the first jejunal vein and artery for the artery-first approach, the implications of the ligament of Treitz on pancreatoduodenectomy, and the nerve plexus anatomy around the pancreatic head. Pancreatoduodenectomy requires comprehensive anatomic knowledge as a form of upper abdominal gastrointestinal surgery. It is important for surgeons to have detailed knowledge of pancreatic anatomy. Recently, laparoscopic pancreatoduodenectomy has become widespread. New perspectives on anatomy can be expected to develop, especially of membranes, fibrous structures, etc., with the benefits of the magnifying effect.

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