The Experts below are selected from a list of 1845 Experts worldwide ranked by ideXlab platform

Yosuke Inoue - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Background and Purpose Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. Methods We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Results Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Conclusions Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

  • surgical anatomy of the Superior Mesenteric Vessels related to colon and pancreatic surgery a systematic review and meta analysis
    Scientific Reports, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    The surgeon dissecting the base of the mesenterium, around the Superior Mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the Superior Mesenteric Vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The Superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the Superior Mesenteric Vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis.
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

Sorin Hostiuc - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Background and Purpose Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. Methods We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Results Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Conclusions Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

  • surgical anatomy of the Superior Mesenteric Vessels related to colon and pancreatic surgery a systematic review and meta analysis
    Scientific Reports, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    The surgeon dissecting the base of the mesenterium, around the Superior Mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the Superior Mesenteric Vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The Superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the Superior Mesenteric Vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis.
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

Ionut Negoi - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Background and Purpose Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. Methods We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Results Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Conclusions Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

  • surgical anatomy of the Superior Mesenteric Vessels related to colon and pancreatic surgery a systematic review and meta analysis
    Scientific Reports, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    The surgeon dissecting the base of the mesenterium, around the Superior Mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the Superior Mesenteric Vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The Superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the Superior Mesenteric Vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis.
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

Mircea Beuran - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Background and Purpose Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. Methods We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Results Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Conclusions Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

  • surgical anatomy of the Superior Mesenteric Vessels related to colon and pancreatic surgery a systematic review and meta analysis
    Scientific Reports, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    The surgeon dissecting the base of the mesenterium, around the Superior Mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the Superior Mesenteric Vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The Superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the Superior Mesenteric Vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis.
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

Ruxandra Irina Negoi - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Background and Purpose Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. Methods We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Results Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Conclusions Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.

  • surgical anatomy of the Superior Mesenteric Vessels related to colon and pancreatic surgery a systematic review and meta analysis
    Scientific Reports, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    The surgeon dissecting the base of the mesenterium, around the Superior Mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the Superior Mesenteric Vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The Superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the Superior Mesenteric Vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  • Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis.
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
    Abstract:

    Mesopancreas dissection with central vascular ligation and the Superior Mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the Superior Mesenteric Vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the Mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the Superior Mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.