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Modification in the technique of pancreaticoduodenectomy: supracolic division of jejunum to facilitate uncinate process dissection.
Hepatogastroenterology. 2007 Sep; 54(78):1728-30.H

Abstract

Pancreaticoduodenectomy remains the recommended procedure for periampullary and pancreatic head tumors. The dissection of the uncinate process from the superior mesenteric vessels is a key step in this surgery. We describe a modification in the existing practice of infracolic division of the jejunum in order to facilitate this step. In this modification, the duodenojejunal (DJ) flexure and the proximal jejunum are delivered into the supracolic compartment and then the jejunum is divided. This exposes the uncinate process completely and facilitates the separation from the Superior Mesenteric Artery (SMA) and the Superior Mesenteric Vein (SMV). We have successfully employed this modified technique for 33 resections since February 2004. This modification of dividing the jejunum in the supracolic compartment is based on sound anatomic and embryologic grounds. It helps in aligning the uncinate process with the jejunal mesentery thereby making the dissection of uncinate process from the superior mesenteric vessels safe and complete.

Authors+Show Affiliations

Department of Gastrointestinal and Hepatopancreatobiliary Surgical Oncology, Tata Memorial Hospital, Mumbai, India. pjshukla@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18019705

Citation

Shukla, P J., et al. "Modification in the Technique of Pancreaticoduodenectomy: Supracolic Division of Jejunum to Facilitate Uncinate Process Dissection." Hepato-gastroenterology, vol. 54, no. 78, 2007, pp. 1728-30.
Shukla PJ, Barreto G, Pandey D, et al. Modification in the technique of pancreaticoduodenectomy: supracolic division of jejunum to facilitate uncinate process dissection. Hepatogastroenterology. 2007;54(78):1728-30.
Shukla, P. J., Barreto, G., Pandey, D., Kanitkar, G., Nadkarni, M. S., Neve, R., & Shrikhande, S. V. (2007). Modification in the technique of pancreaticoduodenectomy: supracolic division of jejunum to facilitate uncinate process dissection. Hepato-gastroenterology, 54(78), 1728-30.
Shukla PJ, et al. Modification in the Technique of Pancreaticoduodenectomy: Supracolic Division of Jejunum to Facilitate Uncinate Process Dissection. Hepatogastroenterology. 2007;54(78):1728-30. PubMed PMID: 18019705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modification in the technique of pancreaticoduodenectomy: supracolic division of jejunum to facilitate uncinate process dissection. AU - Shukla,P J, AU - Barreto,G, AU - Pandey,D, AU - Kanitkar,G, AU - Nadkarni,M S, AU - Neve,R, AU - Shrikhande,S V, PY - 2007/11/21/pubmed PY - 2008/1/15/medline PY - 2007/11/21/entrez SP - 1728 EP - 30 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 54 IS - 78 N2 - Pancreaticoduodenectomy remains the recommended procedure for periampullary and pancreatic head tumors. The dissection of the uncinate process from the superior mesenteric vessels is a key step in this surgery. We describe a modification in the existing practice of infracolic division of the jejunum in order to facilitate this step. In this modification, the duodenojejunal (DJ) flexure and the proximal jejunum are delivered into the supracolic compartment and then the jejunum is divided. This exposes the uncinate process completely and facilitates the separation from the Superior Mesenteric Artery (SMA) and the Superior Mesenteric Vein (SMV). We have successfully employed this modified technique for 33 resections since February 2004. This modification of dividing the jejunum in the supracolic compartment is based on sound anatomic and embryologic grounds. It helps in aligning the uncinate process with the jejunal mesentery thereby making the dissection of uncinate process from the superior mesenteric vessels safe and complete. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/18019705/Modification_in_the_technique_of_pancreaticoduodenectomy:_supracolic_division_of_jejunum_to_facilitate_uncinate_process_dissection_ L2 - https://medlineplus.gov/pancreaticcancer.html DB - PRIME DP - Unbound Medicine ER -