{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:44:18Z","timestamp":1760147058442,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2020YFS0262","21HXFH058","ZYJC21037"],"award-info":[{"award-number":["2020YFS0262","21HXFH058","ZYJC21037"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital Clinical Research Incubation Project","doi-asserted-by":"publisher","award":["2020YFS0262","21HXFH058","ZYJC21037"],"award-info":[{"award-number":["2020YFS0262","21HXFH058","ZYJC21037"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","award":["2020YFS0262","21HXFH058","ZYJC21037"],"award-info":[{"award-number":["2020YFS0262","21HXFH058","ZYJC21037"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The no-touch isolation technique has been widely used in cancer surgery as a strategy to prevent cancer cells from spreading; however, it is difficult to apply in laparoscopic pancreaticoduodenectomy (LPD). Here, we describe an orthotopic resection surgical technique that applies a no-touch principle for LPD and can help with the in situ resection of tumors. In implementing this surgical strategy, Kocher\u2019s maneuver was not performed first. Instead, after the exploration of the abdominal cavity, the distal stomach and the pancreatic neck were transected. Then, the dissection of the uncinate process of the pancreas, the duodenum, and the superior mesenteric vein and artery is carried out via an inferior infracolic approach. Finally, the pancreatic head and duodenum were removed in situ. Among the 41 patients who underwent this technique, two (4.9%) required conversion to open surgery due to uncontrolled bleeding. The average operative time was 335 min (248\u20131055 min). The mean estimated blood loss was 300 mL (50\u20131250 mL). Two patients (4.9%) underwent combined PV resection and reconstruction; six patients (14.6%) required a blood transfusion; two patients (4.9%) suffered from postoperative bleeding; two patients (4.9%) suffered from Grade B pancreatic fistulas; one patient (2.4%) suffered from bile leakage; and three patients (7.3%) suffered from abdominal fluid collection. No patients died during the perioperative period. Therefore, orthotopic LPD using an inferior infracolic approach is safe and feasible for patients with malignant pancreatic head and periampullary tumors. However, further investigations are required to elucidate its oncological benefits.<\/jats:p>","DOI":"10.3390\/jcm12020590","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T03:11:02Z","timestamp":1673493062000},"page":"590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Orthotopic Resection Surgical Technique Using an Inferior Infracolic Approach for Laparoscopic Pancreaticoduodenectomy"],"prefix":"10.3390","volume":"12","author":[{"given":"Yutong","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"},{"name":"Liver Transplantation Center and HBP Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to University of Electronic Science and Technology of China, Chengdu 610042, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1928-4272","authenticated-orcid":false,"given":"Junjie","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xubao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7135-2244","authenticated-orcid":false,"given":"Nengwen","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00595-016-1317-5","article-title":"No-touch isolation techniques for pancreatic cancer","volume":"47","author":"Kuroki","year":"2017","journal-title":"Surg. 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Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.surg.2007.02.001","article-title":"Postpancreatectomy hemorrhage (PPH): An International Study Group of Pancreatic Surgery (ISGPS) definition","volume":"142","author":"Wente","year":"2007","journal-title":"Surgery"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.surg.2016.11.014","article-title":"The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years after","volume":"161","author":"Bassi","year":"2017","journal-title":"Surgery"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3322\/canjclin.18.2.82","article-title":"Cancer of the colon: The influence of the no-touch isolation technic on survival rates","volume":"18","author":"Turnbull","year":"1968","journal-title":"CA Cancer J. Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1002\/bjs.1800750505","article-title":"No-touch isolation technique in colon cancer: A controlled prospective trial","volume":"75","author":"Wiggers","year":"1988","journal-title":"Br. J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1245\/s10434-016-5542-3","article-title":"Inferior Infracolic \u2018Superior Mesenteric Artery First\u2019 Approach with a No-Touch Isolation Surgical Technique in Patients with a Borderline Resectable Cancer of the Pancreatic Head","volume":"23","author":"Zhu","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","first-page":"143","article-title":"Pancreatectomy using the no-touch isolation technique followed by extensive intraoperative peritoneal lavage to prevent cancer cell dissemination: A pilot study","volume":"6","author":"Hirota","year":"2005","journal-title":"JOP"},{"key":"ref_14","first-page":"243","article-title":"No-touch pancreatectomy for invasive ductal carcinoma of the pancreas","volume":"15","author":"Hirota","year":"2014","journal-title":"JOP"},{"key":"ref_15","first-page":"e63450","article-title":"Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer using In-Situ No-Touch Isolation Technique","volume":"2","author":"Shen","year":"2022","journal-title":"J. Vis. Exp."},{"key":"ref_16","first-page":"782","article-title":"Clinical experience of laparoscopic pancreatoduodenectomy via orthotopic resection","volume":"58","author":"Tan","year":"2020","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"ref_17","first-page":"73","article-title":"First experience of laparoscopic no-touch pancreatoduodenectomy","volume":"9","author":"Kopchak","year":"2013","journal-title":"Klin. Khirurhiia"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/2\/590\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:03:10Z","timestamp":1760119390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/2\/590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,11]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12020590"],"URL":"https:\/\/doi.org\/10.3390\/jcm12020590","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,1,11]]}}}