title: Tricks and tips in pancreatoduodenectomy.
abstract: Pancreaticoduodenectomy (PD) is the standard surgical treatment for tumors of the pancreatic head, proximal bile duct, duodenum and ampulla, and represents the only hope of cure in cases of malignancy. Since its initial description in 1935 by Whipple et al, this complex surgical technique has evolved and undergone several modifications. We review three key issues in PD: (1) the initial approach to the superior mesenteric artery, known as the artery-first approach; (2) arterial complications caused by anatomic variants of the hepatic artery or celiac artery stenosis; and (3) the extent of lymphadenectomy.
authors.affiliation: Anna Pallisera, Rafael Morales, Department of Surgery, Hospital Son Llatzer, 07198 Palma de Mallorca, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Pallisera
authors.affiliation: Anna Pallisera, Rafael Morales, Department of Surgery, Hospital Son Llatzer, 07198 Palma de Mallorca, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Morales
authors.affiliation: Anna Pallisera, Rafael Morales, Department of Surgery, Hospital Son Llatzer, 07198 Palma de Mallorca, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ramia
keywords: Artery-first; Celiac axis; Hepatic artery; Lymphadenectomy; Pancreas; Pancreaticoduodenectomy; Surgery