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Pancreaticoduodenectomy for Cancer: Technical Aspects of the Retroperitoneal Soft Tissue Dissection to Maximize a Negative Surgical Margin
Thomas J. Howard*, Nicholas J. Zyromski
Indiana Univ Med Ctr, Indianapolis, IN

Improvements in surgical technique and perioperative care have resulted in low morbidity and mortality rates following pancreaticoduodenectomy in patients with pancreatic cancer. While the operation is safe, achieving a margin negative (R0) resection remains central in improving long-term survival. Of the 4 surgical margins transected (bile duct, duodenal or gastric, pancreatic neck, and retroperitoneal soft tissue), the most complicated conceptually, and the most demanding technically is the retroperitoneal soft tissue margin. This video emphasizes the technical steps taken to maximize the opportunity to achieve a margin-negative R0 resection.


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