{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T18:16:57Z","timestamp":1782325017845,"version":"3.54.5"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T00:00:00Z","timestamp":1573689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T00:00:00Z","timestamp":1573689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1007\/s00423-019-01839-1","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T11:03:03Z","timestamp":1573729383000},"page":"1017-1022","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Pancreatic resection for cancer\u2014the Heidelberg technique"],"prefix":"10.1007","volume":"404","author":[{"given":"Martin","family":"Schneider","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Strobel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Hackert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus W.","family":"B\u00fcchler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,14]]},"reference":[{"issue":"8496","key":"1839_CR1","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1016\/S0140-6736(86)91510-2","volume":"1","author":"RJ Heald","year":"1986","unstructured":"Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479\u20131482","journal-title":"Lancet"},{"issue":"4","key":"1839_CR2","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1111\/j.1463-1318.2008.01735.x","volume":"11","author":"W Hohenberger","year":"2009","unstructured":"Hohenberger W et al (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation\u2014technical notes and outcome. Color Dis 11(4):354\u2013364 discussion 364-5","journal-title":"Color Dis"},{"issue":"2","key":"1839_CR3","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00384-015-2421-5","volume":"31","author":"M Kiehlmann","year":"2016","unstructured":"Kiehlmann M, Weber K, G\u00f6hl J, Fietkau R, Agaimy A, Hohenberger W, Merkel S (2016) The impact of surgical quality on prognosis in patients undergoing rectal carcinoma surgery after preoperative chemoradiation. Int J Color Dis 31(2):247\u2013255","journal-title":"Int J Color Dis"},{"issue":"7","key":"1839_CR4","doi-asserted-by":"publisher","first-page":"E893","DOI":"10.3390\/cancers11070893","volume":"11","author":"G Gasparini","year":"2019","unstructured":"Gasparini G et al (2019) Nerves and pancreatic cancer: new insights into a dangerous relationship. Cancers (Basel) 11(7):E893","journal-title":"Cancers (Basel)"},{"issue":"8","key":"1839_CR5","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1002\/bjs.8734","volume":"99","author":"CS Verbeke","year":"2012","unstructured":"Verbeke CS, Gladhaug IP (2012) Resection margin involvement and tumour origin in pancreatic head cancer. Br J Surg 99(8):1036\u20131049","journal-title":"Br J Surg"},{"issue":"5","key":"1839_CR6","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1097\/SLA.0000000000002234","volume":"267","author":"VP Groot","year":"2018","unstructured":"Groot VP et al (2018) Patterns, timing, and predictors of recurrence following pancreatectomy for pancreatic ductal adenocarcinoma. Ann Surg 267(5):936\u2013945","journal-title":"Ann Surg"},{"issue":"3","key":"1839_CR7","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1245\/s10434-012-2762-z","volume":"20","author":"O Strobel","year":"2013","unstructured":"Strobel O et al (2013) Re-resection for isolated local recurrence of pancreatic cancer is feasible, safe, and associated with encouraging survival. Ann Surg Oncol 20(3):964\u2013972","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"1839_CR8","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/SLA.0000000000002557","volume":"269","author":"P Ghaneh","year":"2019","unstructured":"Ghaneh P, Kleeff J, Halloran CM, Raraty M, Jackson R, Melling J, Jones O, Palmer DH, Cox TF, Smith CJ, O'Reilly DA, Izbicki JR, Scarfe AG, Valle JW, McDonald A, Carter R, Tebbutt NC, Goldstein D, Padbury R, Shannon J, Dervenis C, Glimelius B, Deakin M, Anthoney A, Lerch MM, Mayerle J, Ol\u00e1h A, Rawcliffe CL, Campbell F, Strobel O, B\u00fcchler MW, Neoptolemos JP, European Study Group for Pancreatic Cancer (2019) The impact of positive resection margins on survival and recurrence following resection and adjuvant chemotherapy for pancreatic ductal adenocarcinoma. Ann Surg 269(3):520\u2013529","journal-title":"Ann Surg"},{"issue":"9","key":"1839_CR9","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1002\/bjs.10842","volume":"105","author":"T Hank","year":"2018","unstructured":"Hank T, Hinz U, Tarantino I, Kaiser J, Niesen W, Bergmann F, Hackert T, B\u00fcchler MW, Strobel O (2018) Validation of at least 1 mm as cut-off for resection margins for pancreatic adenocarcinoma of the body and tail. Br J Surg 105(9):1171\u20131181","journal-title":"Br J Surg"},{"issue":"3","key":"1839_CR10","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1097\/SLA.0000000000001731","volume":"265","author":"O Strobel","year":"2017","unstructured":"Strobel O et al (2017) Pancreatic cancer surgery: the new R-status counts. Ann Surg 265(3):565\u2013573","journal-title":"Ann Surg"},{"key":"1839_CR11","unstructured":"Jones, R.P., et al., Patterns of recurrence after resection of pancreatic ductal adenocarcinoma: a secondary analysis of the ESPAC-4 randomized adjuvant chemotherapy trial. JAMA Surg, 2019."},{"issue":"6","key":"1839_CR12","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1097\/MPA.0000000000000564","volume":"45","author":"C Tjaden","year":"2016","unstructured":"Tjaden C et al (2016) Clinical impact of structured follow-up after pancreatic surgery. Pancreas 45(6):895\u2013899","journal-title":"Pancreas"},{"issue":"3","key":"1839_CR13","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1097\/SLA.0000000000001850","volume":"264","author":"T Hackert","year":"2016","unstructured":"Hackert T, Sachsenmaier M, Hinz U, Schneider L, Michalski CW, Springfeld C, Strobel O, J\u00e4ger D, Ulrich A, B\u00fcchler MW (2016) Locally advanced pancreatic cancer: neoadjuvant therapy with folfirinox results in resectability in 60% of the patients. Ann Surg 264(3):457\u2013463","journal-title":"Ann Surg"},{"issue":"8","key":"1839_CR14","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1007\/s00423-018-1724-8","volume":"403","author":"U Klaiber","year":"2018","unstructured":"Klaiber U, Leonhardt CS, Strobel O, Tjaden C, Hackert T, Neoptolemos JP (2018) Neoadjuvant and adjuvant chemotherapy in pancreatic cancer. Langenbeck's Arch Surg 403(8):917\u2013932","journal-title":"Langenbeck's Arch Surg"},{"issue":"1","key":"1839_CR15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/s41571-018-0112-1","volume":"16","author":"O Strobel","year":"2019","unstructured":"Strobel O, Neoptolemos J, J\u00e4ger D, B\u00fcchler MW (2019) Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol 16(1):11\u201326","journal-title":"Nat Rev Clin Oncol"},{"issue":"12","key":"1839_CR16","doi-asserted-by":"publisher","first-page":"2264","DOI":"10.1007\/s11605-015-2958-1","volume":"19","author":"M Del Chiaro","year":"2015","unstructured":"Del Chiaro M et al (2015) Cattel-Braasch maneuver combined with artery-first approach for superior mesenteric-portal vein resection during pancreatectomy. J Gastrointest Surg 19(12):2264\u20132268","journal-title":"J Gastrointest Surg"},{"issue":"8","key":"1839_CR17","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1007\/s00423-010-0663-9","volume":"395","author":"T Hackert","year":"2010","unstructured":"Hackert T, Werner J, Weitz J, Schmidt J, B\u00fcchler MW (2010) Uncinate process first\u2014a novel approach for pancreatic head resection. Langenbeck's Arch Surg 395(8):1161\u20131164","journal-title":"Langenbeck's Arch Surg"},{"issue":"2","key":"1839_CR18","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.jamcollsurg.2009.10.019","volume":"210","author":"J Weitz","year":"2010","unstructured":"Weitz J, Rahbari N, Koch M, B\u00fcchler MW (2010) The \u201cartery first\u201d approach for resection of pancreatic head cancer. J Am Coll Surg 210(2):e1\u2013e4","journal-title":"J Am Coll Surg"},{"issue":"2","key":"1839_CR19","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1111\/j.1477-2574.2009.00037.x","volume":"11","author":"JA Stauffer","year":"2009","unstructured":"Stauffer JA et al (2009) Aberrant right hepatic arterial anatomy and pancreaticoduodenectomy: recognition, prevalence and management. HPB (Oxford) 11(2):161\u2013165","journal-title":"HPB (Oxford)"},{"issue":"9","key":"1839_CR20","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.3748\/wjg.v17.i9.1126","volume":"17","author":"T Heye","year":"2011","unstructured":"Heye T, Zausig N, Klauss M, Singer R, Werner J, Richter GM, Kauczor HU, Grenacher L (2011) CT diagnosis of recurrence after pancreatic cancer: is there a pattern? World J Gastroenterol 17(9):1126\u20131134","journal-title":"World J Gastroenterol"},{"issue":"4","key":"1839_CR21","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.ejso.2011.12.015","volume":"38","author":"M Adham","year":"2012","unstructured":"Adham M, Singhirunnusorn J (2012) Surgical technique and results of total mesopancreas excision (TMpE) in pancreatic tumors. Eur J Surg Oncol 38(4):340\u2013345","journal-title":"Eur J Surg Oncol"},{"issue":"8","key":"1839_CR22","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1002\/bjs.8763","volume":"99","author":"P Sanjay","year":"2012","unstructured":"Sanjay P, Takaori K, Govil S, Shrikhande SV, Windsor JA (2012) Artery-first\u2019 approaches to pancreatoduodenectomy. Br J Surg 99(8):1027\u20131035","journal-title":"Br J Surg"},{"issue":"6","key":"1839_CR23","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1245\/s10434-008-9839-8","volume":"15","author":"I Esposito","year":"2008","unstructured":"Esposito I, Kleeff J, Bergmann F, Reiser C, Herpel E, Friess H, Schirmacher P, B\u00fcchler MW (2008) Most pancreatic cancer resections are R1 resections. Ann Surg Oncol 15(6):1651\u20131660","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"1839_CR24","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1002\/bjs.11115","volume":"106","author":"WS Tummers","year":"2019","unstructured":"Tummers WS et al (2019) Impact of resection margin status on recurrence and survival in pancreatic cancer surgery. Br J Surg 106(8):1055\u20131065","journal-title":"Br J Surg"},{"issue":"4","key":"1839_CR25","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.hpb.2015.11.009","volume":"18","author":"JR Butler","year":"2016","unstructured":"Butler JR, Ahmad SA, Katz MH, Cioffi JL, Zyromski NJ (2016) A systematic review of the role of periadventitial dissection of the superior mesenteric artery in affecting margin status after pancreatoduodenectomy for pancreatic adenocarcinoma. HPB (Oxford) 18(4):305\u2013311","journal-title":"HPB (Oxford)"},{"issue":"6","key":"1839_CR26","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1002\/bjs.10832","volume":"105","author":"N Ironside","year":"2018","unstructured":"Ironside N et al (2018) Meta-analysis of an artery-first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. Br J Surg 105(6):628\u2013636","journal-title":"Br J Surg"},{"issue":"1","key":"1839_CR27","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1186\/s13063-018-3002-z","volume":"19","author":"S Hirono","year":"2018","unstructured":"Hirono S et al (2018) Mesenteric approach vs. conventional approach for pancreatic cancer during pancreaticoduodenectomy: study protocol for a multicenter randomized controlled trial of 354 patients with pancreatic ductal adenocarcinoma. Trials 19(1):613","journal-title":"Trials"},{"issue":"11","key":"1839_CR28","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.hpb.2017.07.007","volume":"19","author":"T Hackert","year":"2017","unstructured":"Hackert T, Strobel O, Michalski CW, Mihaljevic AL, Mehrabi A, M\u00fcller-Stich B, Berchtold C, Ulrich A, B\u00fcchler MW (2017) The TRIANGLE operation - radical surgery after neoadjuvant treatment for advanced pancreatic cancer: a single arm observational study. HPB (Oxford) 19(11):1001\u20131007","journal-title":"HPB (Oxford)"},{"issue":"2","key":"1839_CR29","first-page":"203","volume":"403","author":"A Mitra","year":"2018","unstructured":"Mitra A, Pai E, Dusane R, Ranganathan P, DeSouza A, Goel M, Shrikhande SV (2018) Extended pancreatectomy as defined by the ISGPS: useful in selected cases of pancreatic cancer but invaluable in other complex pancreatic tumors. Langenbeck's Arch Surg 403(2):203\u2013212","journal-title":"Langenbeck's Arch Surg"},{"issue":"12","key":"1839_CR30","doi-asserted-by":"publisher","first-page":"3325","DOI":"10.1158\/0008-5472.CAN-16-1208","volume":"77","author":"KN Yamamoto","year":"2017","unstructured":"Yamamoto KN et al (2017) Personalized management of pancreatic ductal adenocarcinoma patients through computational modeling. Cancer Res 77(12):3325\u20133335","journal-title":"Cancer Res"},{"issue":"5","key":"1839_CR31","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1053\/j.gastro.2018.08.009","volume":"155","author":"UM Mahajan","year":"2018","unstructured":"Mahajan UM, Langhoff E, Goni E, Costello E, Greenhalf W, Halloran C, Ormanns S, Kruger S, Boeck S, Ribback S, Beyer G, Dombroswki F, Weiss FU, Neoptolemos JP, Werner J, D'Haese JG, Bazhin A, Peterhansl J, Pichlmeier S, B\u00fcchler MW, Kleeff J, Ganeh P, Sendler M, Palmer DH, Kohlmann T, Rad R, Regel I, Lerch MM, Mayerle J (2018) Immune cell and stromal signature associated with progression-free survival of patients with resected pancreatic ductal adenocarcinoma. Gastroenterology 155(5):1625\u20131639 e2","journal-title":"Gastroenterology"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-019-01839-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00423-019-01839-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-019-01839-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:15:33Z","timestamp":1605226533000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00423-019-01839-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,14]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["1839"],"URL":"https:\/\/doi.org\/10.1007\/s00423-019-01839-1","relation":{},"ISSN":["1435-2443","1435-2451"],"issn-type":[{"value":"1435-2443","type":"print"},{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,14]]},"assertion":[{"value":"26 September 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}