Abstract
Background The mesopancreas is important during pancreaticoduodenectomy (PD) in patients with periampullary and pancreatic head carcinoma. This study aimed to investigate whether the duodenojejunal uncinate process vein (DJUV) is a useful anatomical landmark for the caudal border of mesopancreatoduodenum resection.MethodsThis study enrolled 100 adult patients with hepatobiliary pancreatic disease who underwent preoperative multidetector-computed tomography (CT). The anatomy of the key blood vessels involved during PD was analyzed by preoperative CT. The DJUV was defined as the vein draining from the upper jejunum to the superior mesenteric vein adjacent to the uncinate process.ResultsAmong 89 cases, the first jejunal vein was the DJUV, whereas the second jejunal vein was the DJUV in 11 cases. The inferior pancreaticoduodenal artery and vein were located on the cranial side of the DJUV in all cases. The distance between the middle colonic artery and the DJUV was within 10 mm in 81% of cases, suggesting that resection of the mesopancreatoduodenum cranial to the DJUV provided sufficient dissection of regional lymph nodes around the superior mesenteric artery.ConclusionThe DJUV may be a useful anatomical landmark for the caudal border of the mesopancreatoduodenum resection during PD.
Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic vein for pancreatic head cancer—a case-control study
