Skip to main content

Pancreatoduodenectomy: Total Mesopancreas Excision Approach

  • Chapter
  • First Online:
Surgical Atlas of Pancreatic Cancer
  • 975 Accesses

Abstract

In 2012, Adham et al. [1] firstly described the application of Total Mesopancreas Excision (TMpE) Approach (Figs. 1.1 and 1.2), for the carcinoma of head of pancreas, which was based on the concept of total mesorectal excision [2]. They defined the contents in the region for the excision to be formed by the superior mesenteric vein, portal vein, superior mesenteric artery, and celiac trunk of the aorta, and they called this region as the “mesopancreas triangle.” Totally 52 patients using the posterior approach of total mesopancreas excision (TMpE) for pancreatic head cancer were reported by them with a very high R0 resection rate of 80.7%, and the 5-year survival rate was significantly improved [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Adham M, Singhirunnusorn J. Surgical technique and results of total mesopancreas excision (TMpE) in pancreatic tumors. Eur J Surg Oncol. 2012;38:340–5.

    Article  CAS  Google Scholar 

  2. Gockel I, Domeyer M, Wolloscheck T, et al. Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space. World J Surg Oncol. 2007;5:44.

    Article  Google Scholar 

  3. Liu YB, Quan ZW, Peng SY. The idea and controversy of total mesopancreas excision (TMpE) in pancreatic head tumors. Zhongguo Shi Yong Wai Ke Za Zhi (in Chinese). 2013;33:856–8.

    Google Scholar 

  4. Wu WG, Wu XS, Li ML, et al. Total mesopancreas excision (TMpE) for pancreatic head tumors with 75 cases report. Zhongguo Shi Yong Wai Ke Za Zhi (in Chinese). 2013;33:859–62.

    Google Scholar 

  5. Wu W, Wang X, Wu X, Li M, Weng H, Cao Y, Bao R, Su S, Lu J, Gong W, Shi W, Gu J, Wang X, Liu Y, Quan Z, Peng S. Total mesopancreas excision for pancreatic head cancer: analysis of 120 cases. Chin J Cancer Res. 2016;28(4):423–8.

    Article  Google Scholar 

  6. Weitz J, Rahbari N, Koch M, Büchler MW. The “artery first” approach for resection of pancreatic head cancer. J Am Coll Surg. 2010;210(2):e1–4.

    Article  Google Scholar 

  7. Jamieson NB, Foulis AK, Oien KA, et al. Positive mobilization margins alone do not influence survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Surg. 2010;251:1003–10.

    Article  Google Scholar 

  8. Zhang Y, Frampton AE, Cohen P, et al. Tumor infiltration in the medial resection margin predicts survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Gastrointest Surg. 2012;16:1875–82.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wang, XA., Liu, Yb. (2020). Pancreatoduodenectomy: Total Mesopancreas Excision Approach. In: Liu, Yb. (eds) Surgical Atlas of Pancreatic Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-32-9864-4_1

Download citation

  • DOI: https://doi.org/10.1007/978-981-32-9864-4_1

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-32-9863-7

  • Online ISBN: 978-981-32-9864-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics