Application of circumvascular technique in pancreaticoduodenectomy

In order to improve the R0 resection rate of pancreaticoduodenectomy (PD) and to assess the resectability in advance, researchers have proposed the concepts of the surgical approaches such as “artery first” and “uncinate process first”. Due to the complex anatomy of the head of pancreas and the high technical difficulty, these surgical approaches are currently applied only in large centers for pancreatic diseases. In order to improve the radicality of malignant pancreaticoduodenal tumor resection and further standardize the surgical criteria for pancreaticoduodenectomy, the authors have proposed the “circumvascular technique”. This article elaborates on this surgical technique and its detailed operation methods, so as to simplify complex surgeries, shorten the learning curve of surgeons, help more surgeons master this technique, and enable more patients to benefit from this surgery.