In 2006, the concept of Artery First Approach for pancreatic cancer surgery was first proposed by Pessaux et al. , then the method of Artery First Approach in pancreatoduodenectomy, which has been worldwide recognized, was proposed by Weitz in 2010 . Many “Artery First Approach” have been reported currently, and the most classic of which called the posterior approach is put forward by Pessaux, namely expand Kocher incision firstly, then the free SMA including the lymphoid tissue and nerve plexus surrounding the artery are dissected at the root of the posterior SMA before the head of pancreas is anatomized, which can not only obviously increase the R0 resection rate of tumor, but also help making accurate judgment for arterial infringement cases in early stage, which avoids blindly expanding the operation range .
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