关键词: 腹腔镜胰十二指肠切除术, 动脉入路, 钩突, 胰腺全系膜切除

Abstract: Management of pancreatic uncinate process in laparoscopic pancreaticoduodenectomy        TAN Zhi-jian*, SHEN Zhan-tao, CHEN Gui-hao, et  al. *Department of Pancreatobiliary Surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China 
Corresponding author: ZHONG Xiao-sheng, E-mail：gzgentle@foxmail.com
Abstract    The laparoscopic pancreatoduodenectomy (LPD) is a demanding abdominal operation that necessitates advanced surgical skills and teamwork. Because of the deep anatomical location and difficult exposure of the pancreatic uncinate process, the treatment of the uncinate process has been the difficult in LPD; complete resection of the uncinate process and mesopancreas has become the cornerstone of LPD. The LPD surgical path and technical aspects were investigated, modified, and optimized by author’s team. The middle and left posterior combined approach was used to correctly deal with the important vascular - inferior pancreaticoduodenal artery (IPDA) in situ,  to ensure safe and complete excision of the uncinate process and mesopancreas, based on the multi-angle arterial approach. This technique is adaptable to a wide range of difficult uncinate process resections and adheres to the No-touch oncologic principles.

Key words: laparoscopic pancreatoduodenectomy, artery approach, pancreatic uncinate process, total mesopancreas excision