Superior mesenteric artery‑first approach for resectable pancreatic head cancer

Wang,Fang-Fei; Lyu,Shao-Cheng; Ren,Zhang-Yong; Zhao,Xin; Zhu,Ji-Qiao; He,Qiang

doi:10.3892/wasj.2022.169

Superior mesenteric artery‑first approach for resectable pancreatic head cancer

Authors:
- Fang-Fei Wang
- Shao-Cheng Lyu
- Zhang-Yong Ren
- Xin Zhao
- Ji-Qiao Zhu
- Qiang He
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Affiliations: Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
Published online on: August 25, 2022 https://doi.org/10.3892/wasj.2022.169
Article Number: 34
Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Superior mesenteric artery‑first approach has been proposed for the surgical treatment of pancreatic head cancer. However, little is known about its effects on resectable pancreatic head cancer. In the present study, data from patients with resectable pancreatic head cancer, who underwent radical pancreatoduodenectomy with or without the superior mesenteric artery‑first approach at from January, 2014 to December, 2019, were retrospectively collected and analyzed. A total of 204 patients were included in the study. The blood loss and blood transfusion of the arterial approach group (n=94) were less than those of the conventional approach group (n=110). Diarrhea occurred in 31 cases (15.2%) of the arterial approach group and in 18 cases (8.8%) of the conventional approach group (P<0.05). A higher rate of R0 resection and a higher number of lymph nodes harvested were achieved in the arterial approach group (P<0.05). The 1‑, 2‑ and 3‑year tumor‑free survival rates of the patients in the arterial approach group were 60.9, 43.2 and 37.9%, respectively, and those of the patients in the conventional approach group were 64.2, 24.9 and 15.6%, respectively (P<0.05). Moreover, the 1‑, 2‑, and 3‑year overall survival rates of the patients in the arterial approach group were 79.5, 49.7 and 36.7%, and those of the patients in the conventional approach group were and 75.9, 38.6 and 18.7%, respectively (P<0.05). On the whole, the present study demonstrates that the superior mesenteric artery‑first approach can reduce intraoperative blood loss and consequent blood transfusion, facilitate the achievement of an R0 resection, and thus prolong the survival of patients, despite resulting in a higher rate of diarrhea.

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