| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Expert Survey on Chyle Leakage After Pancreaticoduodenectomy: The Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic Surgery (PAM-HBP Surgery) Project 2024. |
| 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 | pp.Online ahead of print |
| 著者・共著者 | Hitoe Nishino, Atsushi Oba, Keiichi Akahoshi, Taiga Wakabayashi, Chang Moo Kang, Shin-E Wang, Deeksha Kapoor, Benedict Kinny-Köster, Ramiro Fernández-Placencia, Yasuko Matsuo, Kenichiro Araki, Shintaro Kuroda, Sohei Satoi, Taizo Hibi, Tsutomu Fujii, Masayuki Sho, Takao Ohtsuka, Masafumi Nakamura, Itaru Endo, Yuichi Nagakawa, Masayuki Ohtsuka |
| 発行年月 | 2026/05 |
| 概要 | BACKGROUND/PURPOSE:Chyle leakage (CL) after pancreaticoduodenectomy (PD) remains an underestimated complication with a consistent incidence. This expert survey analyzed its occurrence from anatomical and surgical perspectives.METHODS:A structured survey was distributed to 57 surgeons from 10 countries, with extensive experience in open and minimally-invasive pancreatectomy.RESULTS:Most experts reported CL incidence as: open ≥ laparoscopic, open > robotic, and laparoscopic = robotic. They identified three major anatomical pitfalls: (i) the transverse mesocolon on the ventral side of the superior mesenteric artery and vein (SMA/SMV), (ii) the meso-jejunum on the dorsal side of the SMA/SMV, and (iii) the fusion fascia of Treitz on the ventral side of the inferior vena cava (IVC). For lymphatic dissection and control, energy devices were favored across all approaches, whereas ligation was more common in open PD and clipping more frequent in robotic PD. Opinions on the optimal dissection plane at the fusion fascia of Treitz varied: along the pancreatic surface (21%), within the fascia (31%), or exposing the IVC (38%).CONCLUSIONS:Expert opinions suggest that the incidence of CL after PD does not differ significantly between open and minimally invasive approaches. Consensus emerged regarding common anatomical pitfalls, which may inform strategies for prevention. |
| DOI | 10.1002/jhbp.70135 |
| PMID | 42186132 |