title: The Standardization of Pancreatoduodenectomy: Where Are We?
abstract: Pancreaticoduodenectomy (PD) represents an important challenge for surgeons due to the complexity of the operation, requirement for technical skills and experience, and postoperative management involving important and life-threatening complications. Despite efforts to reduce mortality in high-volume centers, the morbidity rate is still high (approximately 40-50%). The PD standardization process of surgical aspects and preoperative and postoperative settings is essential to permit pancreatic surgeons to communicate in the same language, compare experiences and results, and to improve the short- and long-term outcomes. The aim of this article is to assess the state of the art practices for important matters of debate for PD (the role of mini invasive approach, the definition and the role of mesopancreas, the extent of lymphadenectomy, the different methods of reconstructions, the prophylactic drainage of the abdominal cavity), and to suggest possible future studies.
authors.affiliation: From the HBP Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Universite Claude Bernard Lyon 1, Lyon, France.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Nappo
authors.forename: Julie
authors.initials: J
authors.lastname: Perinel
authors.forename: Michel
authors.initials: M
authors.lastname: El Bechwaty
authors.forename: Mustapha
authors.initials: M
authors.lastname: Adham
mesh_terms: D004322:Drainage / Q000379:methods / Q000592:standards; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods / Q000592:standards; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000592:standards; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods* / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic / Q000592:standards; D012015:Reference Standards