Short-term and long-term efficacy of artery-first approach <i>versus</i> standard approach pancreaticoduodenectomy: a meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Xin ^1,2 ,  LEI Zehua ^1,2 , GAO Fengwei ^1,2 , XIE Qingyun ^1,2 , JIANG Kangyi ^1,2 , GONG Jie ^1,2

1. Department of Hepatopancreaticobiliary Surgery, Leshan People’s Hospital of Sichuan Province, Leshan, Sichuan 614000, P. R. China;
2. Diagnosis and Treatment Center for Liver, Gallbladder, Pancreas, and Spleen System Diseases, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

LEI Zehua, Email: leitsehua@126.com

Keywords：

artery-first approach; standard approach; pancreaticoduodenectomy; meta-analysis

DOI：

10.7507/1007-9424.202009101

Video：

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Objective To compare the short- and long-term efficacy of artery-first approach pancreatico-duodenectomy (AF-PD) and standard approach pancreaticoduodenectomy (S-PD).Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang, and CNKI databases were searched, relevant literatures were included, and relevant data were extracted for meta-analysis.Results A total of 30 articles were included, including 2 750 cases underwent pancreaticoduodenectomy. The results of meta-analysis showed that in terms of short-term efficacy when compared with S-PD group, the AF-PD group had less intraoperative blood loss (WMD=–175.87, P<0.001), lower intraoperative blood transfusion rate (OR=0.36, P=0.002), higher R0 resection rate (OR=1.83, P<0.001), lower postoperative pancreatic leakage rate (OR=0.71, P=0.005), and shorter postoperative hospital stay (WMD=–2.69, P=0.007). However, there were no statistically significant differences in the operation time and overall postoperative complication rate between the two groups (P>0.05). In terms of long-term efficacy when compared with S-PD group, the AF-PD group had lower tumor local recurrence rate (OR=0.43, P=0.004) and tumor liver metastasis rate (OR=0.60, P=0.010), but had higher 1-year (OR=1.95, P=0.007), 2-year (OR=2.04, P<0.001), 3-year (OR=2.09, P=0.001), and 5-year (OR=2.06, P=0.003) overall survival rates, and there were no significant differences in the rates of lung metastasis and peritoneal metastasis between the two groups (P>0.05).Conclusions AF-PD is better than S-PD in some short-term and long-term outcome indicators such as R0 resection rate, pancreatic leakage rate, overall survival rate, and so on. However, due to the limited quality of the included literatures, more high-quality studies are still needed to verify in the future.

Citation： ZHAO Xin, LEI Zehua, GAO Fengwei, XIE Qingyun, JIANG Kangyi, GONG Jie. Short-term and long-term efficacy of artery-first approach versus standard approach pancreaticoduodenectomy: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 920-929. doi: 10.7507/1007-9424.202009101 Copy

1.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of vater. Ann Surg, 1935, 102(4): 763-779.
2.	Kim JR, Kim HB, Kwon W, et al. Different pattern of recurrence after pancreatoduodenectomy according to the origin of peri-ampullary cancer. Pancreatology, 2018, 18(4 Suppl): S159-S160.
3.	Sandini M, Ruscic KJ, Ferrone CR, et al. Major complications independently increase long-term mortality after pancreatoduodenectomy for cancer. J Gastrointest Surg, 2019, 23(10): 1984-1990.
4.	Strobel O, Hank T, Hinz U, et al. Pancreatic cancer surgery: The new R-status counts. Ann Surg, 2017, 265(3): 565-573.
5.	隋宇航, 孙备. 胰腺癌临床研究的热点问题. 中国普通外科杂志, 2019, 28(3): 255-259.
6.	Weitz J, Rahbari N, Koch M, et al. The “artery first” approach for resection of pancreatic head cancer. J Am Coll Surg, 2010, 210(2): e1-e4.
7.	Horiguchi A, Ishihara S, Ito M, et al. Pancreatoduodenectomy in which dissection of the efferent arteries of the head of the pancreas is performed first. J Hepatobiliary Pancreat Surg, 2007, 14(6): 575-578.
8.	Vallance AE, Young AL, Pandanaboyana S, et al. Posterior superior mesenteric artery first dissection versus classical approach in pancreaticoduodenectomy: Outcomes of a case-matched study. Pancreas, 2017, 46(2): 276-281.
9.	Sabater L, Cugat E, Serrablo A, et al. Does the artery-first approach improve the rate of R0 resection in pancreatoduodenectomy? A multi-center, randomized, controlled trial. Ann Surg, 2019, 270(5): 738-746.
10.	Wells GA, She a B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. 2012-01-18. http://www.ohri.ca/programs/clinical_epidemiology/nosgen.pdf.
11.	Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343(7829): 889-893.
12.	Kawai M, Tani M, Ina S, et al. CLIP method (preoperative CT image-assessed ligation of inferior pancreaticoduodenal artery) reduces intraoperative bleeding during pancreaticoduodenectomy. World J Surg, 2008, 32(1): 82-87.
13.	Figueras J, Codina-Barreras A, López-Ben S, et al. Cephalic duodenopancreatectomy in periampullary tumours. Dissection of the superior mesenteric artery as aninitial approach. Description of the technique and an assessment of our initial experience. Cir Esp, 2008, 83(4): 186-193.
14.	Ishizaki Y, Sugo H, Yoshimoto J, et al. Pancreatoduodenectomy with or without early ligation of the inferior pancreatoduodenal artery: comparison of intraoperative blood loss and short-term outcome. World J Surg, 2010, 34(12): 2939-2944.
15.	Dumitrascu T, David L, Popescu I. Posterior versus standard approach in pancreatoduodenectomy: a case-match study. Langenbecks Arch Surg, 2010, 395(6): 677-684.
16.	Kurosaki I, Minagawa M, Takano K, et al. Left posterior approach to the superior mesenteric vascular pedicle in pancreaticoduode-nectomy for cancer of the pancreatic head. JOP, 2011, 12(3): 220-229.
17.	Shrikhande SV, Barreto SG, Bodhankar YD, et al. Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes. Langenbecks Arch Surg, 2011, 396(8): 1205-1212.
18.	Kawabata Y, Tanaka T, Nishi T, et al. Appraisal of a total meso-pancreatoduodenum excision with pancreaticoduodenectomy for pancreatic head carcinoma. Eur J Surg Oncol, 2012, 38(7): 574-579.
19.	Nakamura M, Nakashima H, Tsutsumi K, et al. First jejunal vein oriented mesenteric excision for pancreatoduodenectomy. J Gastroenterol, 2013, 48(8): 989-995.
20.	Aimoto T, Mizutani S, Kawano Y, et al. Left posterior approach pancreaticoduodenectomy with total mesopancreas excision and circumferential lymphadenectomy around the superior mesenteric artery for pancreatic head carcinoma. J Nippon Med Sch, 2013, 80(6): 438-445.
21.	Gundara JS, Wang F, Alvarado-Bachmann R, et al. The clinical impact of early complete pancreatic head devascularisation during pancreatoduodenectomy. Am J Surg, 2013, 206(4): 518-525.
22.	Shah OJ, Gagloo MA, Khan IJ, et al. Pancreaticoduodenectomy: a comparison of superior approach with classical Whipple’s technique. Hepatobiliary Pancreat Dis Int, 2013, 12(2): 196-203.
23.	Kawabata Y, Nishi T, Tanaka T, et al. Safety and feasibility of a pancreaticoduodenectomy with total meso-pancreatoduodenum excision: Analysis in various periampullary disorders. Hepatogastroenterology, 2014, 61(131): 821-827.
24.	Gall TM, Jacob J, Frampton AE, et al. Reduced dissemination of circulating tumor cells with no-touch isolation surgical technique in patients with pancreatic cancer. JAMA Surg, 2014, 149(5): 482-485.
25.	Zhou HY, Wang Y, Zhang J, et al. Retrograde vs conventional dissection technique in pancreaticoduodenectomy: A pilot study. JAMA Surg, 2014, 149(6): 604-607.
26.	Inoue Y, Saiura A, Yoshioka R, et al. Pancreatoduodenectomy with systematic mesopancreas dissection using a supracolic anterior artery-first approach. Ann Surg, 2015, 262(6): 1092-1101.
27.	李秀东, 王双佳, 周彦明, 等. 动脉优先入路在根治性胰十二指肠切除术中的应用价值. 中华消化外科杂志, 2016, 15(6): 628-633.
28.	Inoue Y, Saiura A, Tanaka M, et al. Technical details of an anterior approach to the superior mesenteric artery during pancreati-coduodenectomy. J Gastrointest Surg, 2016, 20(10): 1769-1777.
29.	Hirono S, Kawai M, Okada KI, et al. Mesenteric approach during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Gastroenterol Surg, 2017, 1(3): 208-218.
30.	Pal S, George J, Singh AN, et al. Posterior superior mesenteric artery (SMA) first approach vs. standard pancreatico- duodenectomy in patients with resectable periampullary cancers: A prospective comparison focusing on circumferential resection margins. J Gastrointest Cancer, 2018, 49(3): 252-259.
31.	Pędziwiatr M, Pisarska M, Małczak P, et al. Laparoscopic uncinate process first pancreatoduodenectomy-feasibility study of a modified ‘artery first’ approach to pancreatic head cancer. Langenbecks Arch Surg, 2017, 402(6): 917-923.
32.	Wang M, Zhang H, Zhu F, et al. Pancreaticoduodenectomy for borderline resectable pancreatic head cancer with a modified artery-first approach technique. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 215-221.
33.	马春阳, 朱峰, 王敏, 等. 动脉优先入路在腹腔镜胰十二指肠切除术中的临床价值. 中华消化外科杂志, 2017, 16(8): 832-838.
34.	金钢, 郑楷炼, 郭世伟, 等. 动脉先行路径胰十二指肠切除治疗交界性可切除胰腺癌的临床疗效分析. 中华外科杂志, 2017, 55(12): 909-915.
35.	Elwahab MA, Nakeeb AE, Ali MAE, et al. Comparative study between posterior approach with mesopancreatectomy versus standard approach in pancreatoduodenectomy: a case control study. Surg Gastroenterol Oncol, 2018, 23(1): 56-63.
36.	Jiang CY, Liang Y, Wang HW, et al. Management of the uncinate process via the artery first approach in laparoscopic pancreato-duodenectomy. J Hepatobiliary Pancreat Sci, 2019, 26(9): 410-415.
37.	Du F, Wang X, Lin H, et al. Pancreaticoduodenectomy with arterial approach of total mesenteric resection of the pancreas for pancreatic head cancer. Gastroenterology Res, 2019, 12(5): 256-262.
38.	Leng KM, Zhong XY, Tai S, et al. Radical modular pancreatoduodenectomy for pancreatic head cancer using a combination of multiple artery-first approaches technique. Medicine (Baltimore), 2019, 98(13): e14976.
39.	Nakao A, Takagi H. Isolated pancreatectomy for pancreatic head carcinoma using catheter bypass of the portal vein. Hepatogastroenterology, 1993, 40(5): 426-429.
40.	Leach SD, Davidson BS, Ames FC, et al. Alternative method for exposure of the retropancreatic mesenteric vasculature during total pancreatectomy. J Surg Oncol, 1996, 61(2): 163-165.
41.	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): 1728-1730.
42.	Sanjay P, Takaori K, Govil S, et al. ‘Artery-first’ approaches to pancreatoduodenectomy. Br J Surg, 2012, 99(8): 1027-1035.
43.	孙明生, 万波, 龚毅, 等. 腹腔镜胰十二指肠切除术相关肠系膜上血管应用解剖学研究. 中国普通外科杂志, 2016, 25(3): 394-400.
44.	Negoi I, Hostiuc S, Runcanu A, et al. Superior mesenteric artery first approach versus standard pancreaticoduodenectomy: a systematic review and meta-analysis. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 127-138.
45.	Ironside N, Barreto SG, Loveday B, et al. Meta-analysis of an artery-first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. Br J Surg, 2018, 105(6): 628-636.
46.	Kwon J, Song KB, Park SY, et al. Comparison of minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma: A propensity score matching analysis. Cancers (Basel), 2020, 12(4): 982.
47.	Brown JA, Zenati MS, Simmons RL, et al. Long-term surgical complications after pancreatoduodenectomy: Incidence, outcomes, and risk factors. J Gastrointest Surg, 2020, 24(7): 1581-1589.
48.	Haines M, Chua TC, Jamieson NB, et al. Pancreatoduodenectomy with arterial resection for locally advanced pancreatic cancer of the head: A systematic review. Pancreas, 2020, 49(5): 621-628.
49.	Åkerberg D, Ansari D, Bergenfeldt M, et al. Early postoperative fluid retention is a strong predictor for complications after pancreatoduodenectomy. HPB (Oxford), 2019, 21(12): 1784-1789.
50.	Wang W, He Y, Wu L, et al. Efficacy of extended versus standard lymphadenectomy in pancreatoduodenectomy for pancreatic head adenocarcinoma. An update meta-analysis. Pancreatology, 2019, 19(8): 1074-1080.
51.	Smits FJ, van Santvoort HC, Besselink MG, et al. Predicting successful catheter drainage in patients with pancreatic fistula after pancreatoduodenectomy. Pancreas, 2019, 48(6): 811-816.
52.	Mungroop TH, van Rijssen LB, van Klaveren D, et al. Alternative fistula risk score for pancreatoduodenectomy (a-FRS): Design and international external validation. Ann Surg, 2019, 269(5): 937-943.

1. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of vater. Ann Surg, 1935, 102(4): 763-779.
2. Kim JR, Kim HB, Kwon W, et al. Different pattern of recurrence after pancreatoduodenectomy according to the origin of peri-ampullary cancer. Pancreatology, 2018, 18(4 Suppl): S159-S160.
3. Sandini M, Ruscic KJ, Ferrone CR, et al. Major complications independently increase long-term mortality after pancreatoduodenectomy for cancer. J Gastrointest Surg, 2019, 23(10): 1984-1990.
4. Strobel O, Hank T, Hinz U, et al. Pancreatic cancer surgery: The new R-status counts. Ann Surg, 2017, 265(3): 565-573.
5. 隋宇航, 孙备. 胰腺癌临床研究的热点问题. 中国普通外科杂志, 2019, 28(3): 255-259.
6. Weitz J, Rahbari N, Koch M, et al. The “artery first” approach for resection of pancreatic head cancer. J Am Coll Surg, 2010, 210(2): e1-e4.
7. Horiguchi A, Ishihara S, Ito M, et al. Pancreatoduodenectomy in which dissection of the efferent arteries of the head of the pancreas is performed first. J Hepatobiliary Pancreat Surg, 2007, 14(6): 575-578.
8. Vallance AE, Young AL, Pandanaboyana S, et al. Posterior superior mesenteric artery first dissection versus classical approach in pancreaticoduodenectomy: Outcomes of a case-matched study. Pancreas, 2017, 46(2): 276-281.
9. Sabater L, Cugat E, Serrablo A, et al. Does the artery-first approach improve the rate of R0 resection in pancreatoduodenectomy? A multi-center, randomized, controlled trial. Ann Surg, 2019, 270(5): 738-746.
10. Wells GA, She a B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. 2012-01-18. http://www.ohri.ca/programs/clinical_epidemiology/nosgen.pdf.
11. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343(7829): 889-893.
12. Kawai M, Tani M, Ina S, et al. CLIP method (preoperative CT image-assessed ligation of inferior pancreaticoduodenal artery) reduces intraoperative bleeding during pancreaticoduodenectomy. World J Surg, 2008, 32(1): 82-87.
13. Figueras J, Codina-Barreras A, López-Ben S, et al. Cephalic duodenopancreatectomy in periampullary tumours. Dissection of the superior mesenteric artery as aninitial approach. Description of the technique and an assessment of our initial experience. Cir Esp, 2008, 83(4): 186-193.
14. Ishizaki Y, Sugo H, Yoshimoto J, et al. Pancreatoduodenectomy with or without early ligation of the inferior pancreatoduodenal artery: comparison of intraoperative blood loss and short-term outcome. World J Surg, 2010, 34(12): 2939-2944.
15. Dumitrascu T, David L, Popescu I. Posterior versus standard approach in pancreatoduodenectomy: a case-match study. Langenbecks Arch Surg, 2010, 395(6): 677-684.
16. Kurosaki I, Minagawa M, Takano K, et al. Left posterior approach to the superior mesenteric vascular pedicle in pancreaticoduode-nectomy for cancer of the pancreatic head. JOP, 2011, 12(3): 220-229.
17. Shrikhande SV, Barreto SG, Bodhankar YD, et al. Superior mesenteric artery first combined with uncinate process approach versus uncinate process first approach in pancreatoduodenectomy: a comparative study evaluating perioperative outcomes. Langenbecks Arch Surg, 2011, 396(8): 1205-1212.
18. Kawabata Y, Tanaka T, Nishi T, et al. Appraisal of a total meso-pancreatoduodenum excision with pancreaticoduodenectomy for pancreatic head carcinoma. Eur J Surg Oncol, 2012, 38(7): 574-579.
19. Nakamura M, Nakashima H, Tsutsumi K, et al. First jejunal vein oriented mesenteric excision for pancreatoduodenectomy. J Gastroenterol, 2013, 48(8): 989-995.
20. Aimoto T, Mizutani S, Kawano Y, et al. Left posterior approach pancreaticoduodenectomy with total mesopancreas excision and circumferential lymphadenectomy around the superior mesenteric artery for pancreatic head carcinoma. J Nippon Med Sch, 2013, 80(6): 438-445.
21. Gundara JS, Wang F, Alvarado-Bachmann R, et al. The clinical impact of early complete pancreatic head devascularisation during pancreatoduodenectomy. Am J Surg, 2013, 206(4): 518-525.
22. Shah OJ, Gagloo MA, Khan IJ, et al. Pancreaticoduodenectomy: a comparison of superior approach with classical Whipple’s technique. Hepatobiliary Pancreat Dis Int, 2013, 12(2): 196-203.
23. Kawabata Y, Nishi T, Tanaka T, et al. Safety and feasibility of a pancreaticoduodenectomy with total meso-pancreatoduodenum excision: Analysis in various periampullary disorders. Hepatogastroenterology, 2014, 61(131): 821-827.
24. Gall TM, Jacob J, Frampton AE, et al. Reduced dissemination of circulating tumor cells with no-touch isolation surgical technique in patients with pancreatic cancer. JAMA Surg, 2014, 149(5): 482-485.
25. Zhou HY, Wang Y, Zhang J, et al. Retrograde vs conventional dissection technique in pancreaticoduodenectomy: A pilot study. JAMA Surg, 2014, 149(6): 604-607.
26. Inoue Y, Saiura A, Yoshioka R, et al. Pancreatoduodenectomy with systematic mesopancreas dissection using a supracolic anterior artery-first approach. Ann Surg, 2015, 262(6): 1092-1101.
27. 李秀东, 王双佳, 周彦明, 等. 动脉优先入路在根治性胰十二指肠切除术中的应用价值. 中华消化外科杂志, 2016, 15(6): 628-633.
28. Inoue Y, Saiura A, Tanaka M, et al. Technical details of an anterior approach to the superior mesenteric artery during pancreati-coduodenectomy. J Gastrointest Surg, 2016, 20(10): 1769-1777.
29. Hirono S, Kawai M, Okada KI, et al. Mesenteric approach during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Gastroenterol Surg, 2017, 1(3): 208-218.
30. Pal S, George J, Singh AN, et al. Posterior superior mesenteric artery (SMA) first approach vs. standard pancreatico- duodenectomy in patients with resectable periampullary cancers: A prospective comparison focusing on circumferential resection margins. J Gastrointest Cancer, 2018, 49(3): 252-259.
31. Pędziwiatr M, Pisarska M, Małczak P, et al. Laparoscopic uncinate process first pancreatoduodenectomy-feasibility study of a modified ‘artery first’ approach to pancreatic head cancer. Langenbecks Arch Surg, 2017, 402(6): 917-923.
32. Wang M, Zhang H, Zhu F, et al. Pancreaticoduodenectomy for borderline resectable pancreatic head cancer with a modified artery-first approach technique. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 215-221.
33. 马春阳, 朱峰, 王敏, 等. 动脉优先入路在腹腔镜胰十二指肠切除术中的临床价值. 中华消化外科杂志, 2017, 16(8): 832-838.
34. 金钢, 郑楷炼, 郭世伟, 等. 动脉先行路径胰十二指肠切除治疗交界性可切除胰腺癌的临床疗效分析. 中华外科杂志, 2017, 55(12): 909-915.
35. Elwahab MA, Nakeeb AE, Ali MAE, et al. Comparative study between posterior approach with mesopancreatectomy versus standard approach in pancreatoduodenectomy: a case control study. Surg Gastroenterol Oncol, 2018, 23(1): 56-63.
36. Jiang CY, Liang Y, Wang HW, et al. Management of the uncinate process via the artery first approach in laparoscopic pancreato-duodenectomy. J Hepatobiliary Pancreat Sci, 2019, 26(9): 410-415.
37. Du F, Wang X, Lin H, et al. Pancreaticoduodenectomy with arterial approach of total mesenteric resection of the pancreas for pancreatic head cancer. Gastroenterology Res, 2019, 12(5): 256-262.
38. Leng KM, Zhong XY, Tai S, et al. Radical modular pancreatoduodenectomy for pancreatic head cancer using a combination of multiple artery-first approaches technique. Medicine (Baltimore), 2019, 98(13): e14976.
39. Nakao A, Takagi H. Isolated pancreatectomy for pancreatic head carcinoma using catheter bypass of the portal vein. Hepatogastroenterology, 1993, 40(5): 426-429.
40. Leach SD, Davidson BS, Ames FC, et al. Alternative method for exposure of the retropancreatic mesenteric vasculature during total pancreatectomy. J Surg Oncol, 1996, 61(2): 163-165.
41. 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): 1728-1730.
42. Sanjay P, Takaori K, Govil S, et al. ‘Artery-first’ approaches to pancreatoduodenectomy. Br J Surg, 2012, 99(8): 1027-1035.
43. 孙明生, 万波, 龚毅, 等. 腹腔镜胰十二指肠切除术相关肠系膜上血管应用解剖学研究. 中国普通外科杂志, 2016, 25(3): 394-400.
44. Negoi I, Hostiuc S, Runcanu A, et al. Superior mesenteric artery first approach versus standard pancreaticoduodenectomy: a systematic review and meta-analysis. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 127-138.
45. Ironside N, Barreto SG, Loveday B, et al. Meta-analysis of an artery-first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. Br J Surg, 2018, 105(6): 628-636.
46. Kwon J, Song KB, Park SY, et al. Comparison of minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma: A propensity score matching analysis. Cancers (Basel), 2020, 12(4): 982.
47. Brown JA, Zenati MS, Simmons RL, et al. Long-term surgical complications after pancreatoduodenectomy: Incidence, outcomes, and risk factors. J Gastrointest Surg, 2020, 24(7): 1581-1589.
48. Haines M, Chua TC, Jamieson NB, et al. Pancreatoduodenectomy with arterial resection for locally advanced pancreatic cancer of the head: A systematic review. Pancreas, 2020, 49(5): 621-628.
49. Åkerberg D, Ansari D, Bergenfeldt M, et al. Early postoperative fluid retention is a strong predictor for complications after pancreatoduodenectomy. HPB (Oxford), 2019, 21(12): 1784-1789.
50. Wang W, He Y, Wu L, et al. Efficacy of extended versus standard lymphadenectomy in pancreatoduodenectomy for pancreatic head adenocarcinoma. An update meta-analysis. Pancreatology, 2019, 19(8): 1074-1080.
51. Smits FJ, van Santvoort HC, Besselink MG, et al. Predicting successful catheter drainage in patients with pancreatic fistula after pancreatoduodenectomy. Pancreas, 2019, 48(6): 811-816.
52. Mungroop TH, van Rijssen LB, van Klaveren D, et al. Alternative fistula risk score for pancreatoduodenectomy (a-FRS): Design and international external validation. Ann Surg, 2019, 269(5): 937-943.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Short-term and long-term efficacy of artery-first approach versus standard approach pancreaticoduodenectomy: a meta-analysis

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