{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:26:55Z","timestamp":1777908415848,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T00:00:00Z","timestamp":1529020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Charitable Trust SOYU Medical Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early ligation of the inferior pancreatoduodenal artery has been advocated to reduce blood loss during pancreatoduodenectomy. However, the impact of early ligation of the dorsal pancreatic artery (<jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>) remains unclear. This study was performed to investigate the clinical implications of early ligation of the <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From October 2014 to April 2017, 34 consecutive patients underwent pancreatoduodenectomy using a mesenteric approach. The patients were divided into the early <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> ligation group (<jats:italic>n<\/jats:italic> = 15) and late <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> ligation group (<jats:italic>n<\/jats:italic> = 19). The clinical features were retrospectively compared between the two groups (H29\u2010044).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative multidetector row computed tomography and intraoperative findings revealed that the right branch of the <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> supplied the pancreatic head region in all cases. Intraoperative blood loss was significantly lower in the early than late ligation group (median 609 ml [range 94\u20131,013 ml] vs. 764 ml [range 367\u20131,828 ml], respectively; <jats:italic>P<\/jats:italic> = 0.008). Multivariable analysis revealed that early <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> ligation was independently associated with blood loss (<jats:italic>P<\/jats:italic> = 0.023). The <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>s arising from the superior mesenteric artery underwent early ligation at a significantly higher rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early ligation of the <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> during pancreaticoduodenectomy with a mesenteric approach could reduce intraoperative blood loss.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.562","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T23:15:19Z","timestamp":1525994119000},"page":"329-334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy"],"prefix":"10.1002","volume":"25","author":[{"given":"Kiyotsugu","family":"Iede","sequence":"first","affiliation":[{"name":"Department of Surgery Nagoya Central Hospital 3\u20107\u20107 Taiko, Nakamura\u2010ku Nagoya 453\u20100801 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akimasa","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Surgery Nagoya Central Hospital 3\u20107\u20107 Taiko, Nakamura\u2010ku Nagoya 453\u20100801 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Surgery Nagoya Central Hospital 3\u20107\u20107 Taiko, Nakamura\u2010ku Nagoya 453\u20100801 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Surgery Nagoya Central Hospital 3\u20107\u20107 Taiko, Nakamura\u2010ku Nagoya 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