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International expert consensus on precision anatomy for minimally invasive pancreatoduodenectomy: PAM-HBP surgery project
- Publication Year :
- 2021
- Publisher :
- John Wiley and Sons Inc, 2021.
-
Abstract
- Background The anatomical structure around the pancreatic head is very complex, and it is important to understand its precise anatomy and corresponding anatomical approach to safely perform minimally invasive pancreatoduodenectomy (MIPD). This consensus statement aimed to develop recommendations for elucidating the anatomy and surgical approaches to MIPD. Methods Studies identified via a comprehensive literature search were classified using the Scottish Intercollegiate Guidelines Network method. Delphi voting was conducted after experts had drafted recommendations, with a goal of obtaining >75% consensus. Experts discussed the revised recommendations with the validation committee and an international audience of 384 attendees. Finalized recommendations were made after a second round of online Delphi voting. Results Three clinical questions were addressed, providing six recommendations. All recommendations reached at least a consensus of 75%. Preoperatively evaluating the presence of anatomical variations and superior mesenteric artery (SMA) and superior mesenteric vein (SMV) branching patterns was recommended. Moreover, it was recommended to fully understand the anatomical approach to SMA and intraoperatively confirm the SMA course based on each anatomical landmark before initiating dissection. Conclusions MIPD experts suggest to surgical trainees to perform resection based on precise anatomical landmarks for safe and reliable MIPD.
- Subjects :
- consensus
minimally invasive surgical procedures
pancreatoduodenectomy
robotic surgery
superior mesenteric artery
Pancreaticoduodenectomy
Mesenteric Veins
Mesenteric Artery, Superior
Medicine
Humans
Robotic surgery
Superior mesenteric vein
Pancreas
computer.programming_language
Surgical approach
Hepatology
business.industry
Portal Vein
Expert consensus
Anatomy
SMA
Anatomical landmark
Dissection
Surgery
business
computer
Delphi
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....d23d81b87cab00169656826c71eddeb5