{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T23:40:20Z","timestamp":1792539620325,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic & Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"\n Background:<\/jats:title>\n Periarterial divestment has emerged as an artery-preserving alternative to formal arterial resection for borderline resectable and locally advanced pancreatic cancer. However, the available evidence remains limited. This study aimed to evaluate the perioperative and oncologic outcomes of periarterial divestment in pancreatic cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A systematic review was conducted using PubMed, Scopus, Web of Science, and the Cochrane Central Register to identify studies\u2019 data published up to March 2026. Continuous outcomes were pooled as means with 95% confidence intervals (CIs), and binary outcomes were pooled as proportions using random-effects models. Heterogeneity was assessed using the\n I<\/jats:italic>\n 2<\/jats:sup>\n statistic and the Cochrane Q test. Sensitivity analyses were performed using leave-one-out methods. All analyses were conducted in R version 4.4.2.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Five retrospective observational studies comprising 474 patients were included, of whom 92.8% had locally advanced pancreatic cancer and 64.8% received neoadjuvant therapy. The pooled operative time was 333.0 minutes (95% CI: 232.6\u2013433.4;\n \n I\n 2<\/jats:sup>\n =\n <\/jats:italic>\n 99%), estimated blood loss was 620.6 mL (95% CI: 292.4\u2013948.7;\n \n I\n 2<\/jats:sup>\n =\n <\/jats:italic>\n 97%), and length of hospital stay was 12.4 days (95% CI: 9.1\u201315.6;\n \n I\n 2<\/jats:sup>\n =\n <\/jats:italic>\n 99%). The pooled incidence of intraabdominal infection, postoperative pancreatic fistula, postpancreatectomy hemorrhage, delayed gastric emptying, reoperation, major complications (Clavien\u2013Dindo grade \u2265 III), and 90-day mortality was 10.57%, 8.72%, 8.56%, 14.13%, 3.36%, 11.27%, and 4.18%, respectively. The pooled rates of venous resection, arterial resection, and R0 resection were 36.18%, 3.56%, and 43.33%, respectively. The pooled 1-year and 3-year disease-free survival rates were 50.42% and 17.77%, respectively, while the corresponding overall survival rates were 75.99% and 29.11%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Periarterial divestment has been applied in selected patients, with reported perioperative and oncologic outcomes across studies. However, the current evidence remains descriptive and does not allow comparative inference.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10926429261458126","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T09:24:24Z","timestamp":1780910664000},"page":"861-871","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Periarterial Divestment in Locally Advanced Pancreatic Cancer: Systematic Review and Single-Arm Meta-Analysis"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1547-2337","authenticated-orcid":false,"given":"Philipe Franco do Amaral","family":"Tafner","sequence":"first","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0844-000X","authenticated-orcid":false,"given":"J\u00falia Paiva","family":"Behs","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda de Moraes","family":"Nava","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Lima Ulisses","family":"Trindade","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Theis","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Mazzola","family":"Poli de Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Del Grande","sequence":"additional","affiliation":[{"name":"Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio Israel Lima Castelo Branco","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexsander Kuroiwa","family":"Bressan","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2960-3810","authenticated-orcid":false,"given":"Bernardo Fontel","family":"Pompeu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."},{"name":"University of S\u00e3o Caetano do Sul, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0017"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318263da2f"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2021.02.020"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2016.336"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10842"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.02.001"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/120207"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001065"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.08.030"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"11.Tafner PFA Nava FM Behs J et al. 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