Resection Criteria in Pancreatic Surgery: Lymphadenectomy and Vascular Resections

  • Marco Del Chiaro
  • Ugo Boggi
  • Franco Mosca
Part of the Updates in Surgery book series (UPDATESSURG)


Pancreatic carcinoma is generally considered a systemic disease; at diagnosis the disease is often metastatic [1], and its early spread via the lymphatic and blood circulation is well documented by the identification of tumor cells at the level of the cardiovascular system in around 28% of cases and of the marrow in around 24% of cases [2]. However, the poor resectability of pancreatic cancer is also due to local progression, which is also often detected at diagnosis. Approximately 30% of patients diagnosed as having pancreatic carcinoma are excluded from resective surgery owing to suspected involvement of the large vessels of the retropancreatic region (portal mesenteric venous axis, superior mesenteric artery, celiac trunk) [3]. In the early 1970s, Fortner [4] introduced the concept of regional pancreatectomy as a way to achieve higher surgical resection for improved local control of the disease and better lymphatic clearance. Fortner’s experience has been reproduced by various authors with different results and sometimes controversial conclusions.


Pancreatic Cancer Superior Mesenteric Artery Pancreatic Carcinoma Superior Mesenteric Vein Pancreatic Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Marco Del Chiaro
    • 1
  • Ugo Boggi
    • 1
  • Franco Mosca
    • 2
  1. 1.Division of General and Transplant Surgery in Uremic and Diabetic PatientsPisa University HospitalPisaItaly
  2. 2.Department of Oncology, Transplantation and New Technologies Medicine, 1st Division of General SurgeryPisa University HospitalPisaItaly

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