{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:02:00Z","timestamp":1773327720672,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T00:00:00Z","timestamp":1415059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2015,2]]},"abstract":"Abstract\u2003<\/jats:title>Borderline resectable (BR) pancreatic cancer involves the portal vein and\/or superior mesenteric vein (PV<\/jats:styled-content>\/SMV<\/jats:styled-content>), major arteries including the superior mesenteric artery (SMA<\/jats:styled-content>) or common hepatic artery (CHA<\/jats:styled-content>), and sometimes includes the involvement of the celiac axis. We herein describe tips and tricks for a surgical technique with video assistance, which may increase the R0<\/jats:styled-content> rates and decrease the mortality and morbidity for BR<\/jats:styled-content> pancreatic cancer patients. First, we describe the techniques used for the \u201cartery\u2010first\u201d approach for BR<\/jats:styled-content> pancreatic cancer with involvement of the PV<\/jats:styled-content>\/SMV<\/jats:styled-content> and\/or SMA<\/jats:styled-content>. Next, we describe the techniques used for distal pancreatectomy with en\u2010bloc celiac axis resection (DP\u2010CAR<\/jats:styled-content>) and tips for decreasing the delayed gastric emptying (DGE<\/jats:styled-content>) rates for advanced pancreatic body cancer. The mesenteric approach, followed by the dissection of posterior tissues of the SMV<\/jats:styled-content> and SMA<\/jats:styled-content>, is a feasible procedure to obtain R0<\/jats:styled-content> rates and decrease the mortality and morbidity, and the combination of this aggressive procedure and adjuvant chemo(radiation) therapy may improve the survival of BR<\/jats:styled-content> pancreatic cancer patients. The DP\u2010CAR<\/jats:styled-content> procedure may increase the R0 rates for pancreatic cancer patients with involvement within 10\u2009mm from the root of the splenic artery, as well as the CHA<\/jats:styled-content> or celiac axis, and preserving the left gastric artery may lead to a decrease in the DGE<\/jats:styled-content> rates in cases where there is more than 10\u2009mm between the tumor edge and the root of the left gastric artery. The development of safer surgical procedures is necessary to improve the survival of BR<\/jats:styled-content> pancreatic cancer patients.<\/jats:p>","DOI":"10.1002\/jhbp.184","type":"journal-article","created":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T08:51:40Z","timestamp":1415091100000},"source":"Crossref","is-referenced-by-count":13,"title":["Tips and tricks of the surgical technique for borderline resectable pancreatic cancer: mesenteric approach and modified distal pancreatectomy with en\u2010bloc celiac axis resection"],"prefix":"10.1002","volume":"22","author":[{"given":"Seiko","family":"Hirono","sequence":"first","affiliation":[{"name":"Second Department of Surgery Wakayama Medical University School of Medicine 811\u20101 Kimiidera Wakayama 641\u20108510 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Yamaue","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Wakayama Medical University School of Medicine 811\u20101 Kimiidera Wakayama 641\u20108510 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,4]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization: Regional Office for Europe.The European health report 2012: charting the way to well\u2010being.2012."},{"key":"e_1_2_6_3_1","volume-title":"SEER cancer statistics review, 1975\u20132009 posted to the SEER web site, April 2012","author":"Howlader NNA","year":"2011"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-009-0190-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0438-6"},{"key":"e_1_2_6_6_1","first-page":"307","article-title":"Regional resection of cancer of the pancreas: a new surgical approach","volume":"73","author":"Fortner JG","year":"1973","journal-title":"Surgery"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.08.011"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0416-6"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0408-6"},{"key":"e_1_2_6_10_1","unstructured":"National Comprehensive Cancer Network.NCCN practice guidelines for pancreatic cancer version 2. 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