Distal pancreatectomy with en-bloc celiac axis resection (DP-CAR) through retroperitoneal-first laparoscopic approach (Retlap): A novel strategy for achieving accurate evaluation of resectability and minimal invasiveness.
Journal:
Surgical oncology
PMID:
30851918
Abstract
BACKGROUND: Distal pancreatectomy with en-bloc celiac axis resection (DP-CAR) for borderline resectable pancreatic body cancer is increasingly being performed [1,2]. For survival benefits, obtaining margin-free resection (R0 resection) is crucial [3]. However, in patients with cancer abutting the root of the celiac axis and/or SMA, accurate resectability using preoperative imaging is difficult to judge [4]. Recently, we developed a novel strategy named "Retlap: Retroperitoneal-first laparoscopic approach" to achieve accurate evaluation of resectability and minimal invasiveness for difficult hepatopancreatobiliary malignancies and retroperitoneal tumors. Retlap enables direct evaluation of invasion of the roots of the celiac axis and SMA through the retroperitoneal approach.