阴性切缘是胰头癌手术切除后最重要的预后因素已被广泛接受，而胰腺系膜是导致切缘阳性最主要的部位。尽管胰腺系膜和胰腺全系膜切除理念存在着争议，仍有报道显示胰腺全系膜切除在胰后方清扫和提高R0切除率方面有确切优势。我们相信胰腺全系膜切除是全新的理念，其临床应用有希望改善胰头癌病人预后，但仍需后续大样本量研究以提高该术式在胰头癌手术中的科学依据支持强度。

The idea and controversy of total mesopancreas excision (TMpE) in pancreatic head tumors        LIU Ying-bin*, QUAN Zhi-wei, PENG Shu-you.*Institute of Biliary Tract Disease, Shanghai Jiao Tong University School of Medicine; Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine,Shanghai200092，China
Corresponding author:LIU Ying-bin，E-mail:laoniulyb@163.com
Abstract    It is widely accepted that negative resection margins represent the most important prognostic factor after curative intent surgery for pancreatic head adenocarcinoma and the mesopancreas represents the primarily site for positive resection margins. Although the idea of mesopancreas and total mesopancreas excision(TMpE) are controversial, It is reported that  TMpE clearly shows an advantage in improving posterior clearance and R0 resection. We believe that TMpE appears to be a novel and promising surgical procedure for the improvement of prognosis in pancreatic head cancer. However, further studies on larger numbers of patients are mandatory to raise the level of evidence for this approach for surgery of the pancreatic head cancer.