ホンダ　ゴロウ   Goro Honda   本田　五郎    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Surgical approaches for minimally invasive distal pancreatectomy: A systematic review.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国外
巻・号・頁	29(1),pp.151-160
著者・共著者	Ban Daisuke, Garbarino Giovanni Maria, Ishikawa Yoshiya, Honda Goro, Jang Jin-Young, Kang Chang Moo, Maekawa Aya, Murase Yoshiki, Nagakawa Yuichi, Nishino Hitoe, Ohtsuka Takao, Yiengpruksawan Anusak, Endo Itaru, Tsuchida Akihiko, Nakamura Masafumi,
発行年月	2022/01
概要	BACKGROUND:Minimally invasive distal pancreatectomy (MIDP) was initially performed for benign tumors, but recently its indications have steadily broadened to encompass other conditions including pancreatic malignancies. Thorough anatomical knowledge is mandatory for precise surgery in the era of minimally invasive surgery. However, expert consensus regarding anatomical landmarks to facilitate the safe performance of MIDP is still lacking.METHODS:A systematic literature search was performed using keywords to identify articles regarding the vascular anatomy and surgical approaches/techniques for MIDP.RESULTS:All of the systematic reviews revealed that MIDP was not associated with an increase in postoperative complications. Moreover, most showed that MIDP resulted in less blood loss than open surgery. Regarding surgical approaches for MIDP, a standardized stepwise procedure improved surgical outcomes, including blood loss, operative time, and major complications. There are two approaches to the splenic vessels, superior and inferior; however, no study has ever directly compared them with respect to clinical outcomes. The morphology of the splenic artery affects the difficulty of approaching the artery's root. To select an appropriate dissecting layer when performing posterior resection, thorough knowledge of the anatomy of the fascia, left renal vein/artery, and left adrenal gland is needed.CONCLUSIONS:In MIDP, a standardized approach and precise knowledge of anatomy facilitates safe surgery and has the advantage of a shorter learning curve. Anatomical features and landmarks are particularly important in cases of radical MIDP and splenic vessel preserving MIDP.
DOI	10.1002/jhbp.902
PMID	33527758