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Artery first approach to pancreatoduodenectomy: Current status

Lookup NU author(s): Sanjay PandanaboyanaORCiD


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© 2016 Royal Australasian College of Surgeons.Background: The need for an early determination of resectability and before an irreversible step is taken during pancreatoduodenectomy promoted the development of an 'artery first approach' (AFA). The aim of this study was to review the current evidence related to this approach, with particular reference to margins and survival. Methods: An electronic search was performed in MEDLINE, EMBASE and PubMed databases from 1960 to 2015 using both subject headings (MeSH) and truncated word searches to identify all published related articles to this topic. Results: Six different AFAs have been published. Four studies evaluated the impact of AFA on perioperative outcomes and survival. Three studies showed no difference in the perioperative outcomes, margin status, lymph node yield and survival while one study showed improved margin status and survival comparing AFA with standard resection. Conclusion: The current evidence regarding the benefits of AFA in relation to decreasing margin positivity or increasing survival is sparse. Further larger studies and randomized controlled trails are needed to ascertain the benefits of AFA.

Publication metadata

Author(s): Pandanaboyana S, Bell R, Windsor J

Publication type: Review

Publication status: Published

Journal: ANZ Journal of Surgery

Year: 2016

Volume: 86

Issue: 3

Pages: 127-132

Print publication date: 03/03/2016

Online publication date: 05/08/2015

Acceptance date: 01/06/2015

ISSN (print): 1445-1433

ISSN (electronic): 1445-2197

Publisher: Blackwell Publishing


DOI: 10.1111/ans.13249

PubMed id: 26246127