Feng P, Cheng B, Wang ZD, Liu JG, Fan W, Liu H, Qi CY, Pan JJ. Application and progress of medical imaging in total mesopancreas excision for pancreatic head carcinoma. World J Gastrointest Surg 2021; 13(11): 1315-1326 [PMID: 34950422 DOI: 10.4240/wjgs.v13.i11.1315]
Corresponding Author of This Article
Jing-Jing Pan, MD, Associate Chief Physician, Department of Radiology, PLA Rocket Force Characteristic Medical Center, No. 16 Xinwai Street, Beijing 100088, China. panjingjing3969@sina.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2021; 13(11): 1315-1326 Published online Nov 27, 2021. doi: 10.4240/wjgs.v13.i11.1315
Application and progress of medical imaging in total mesopancreas excision for pancreatic head carcinoma
Pei Feng, Bo Cheng, Zhen-Dong Wang, Jun-Gui Liu, Wei Fan, Heng Liu, Chao-Ying Qi, Jing-Jing Pan
Pei Feng, Wei Fan, Heng Liu, Chao-Ying Qi, Jing-Jing Pan, Department of Radiology, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
Bo Cheng, Department of Pathology, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
Zhen-Dong Wang, Department of Ultrasound, Beijing Sihui Hospital of Traditional Chinese Medicine, Beijing 100022, China
Jun-Gui Liu, Department of Hepatobiliary Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
Author contributions: Feng P, Cheng B, Wang ZD, Liu JG and Pan JJ contributed guarantors of integrity of entire study; Cheng B and Pan JJ contributed study design; all authors contributed data acquisition and interpretation; Feng P, Cheng B, Wang ZD and Pan JJ contributed manuscript drafting and revision; all authors contributed literature research; all authors contributed approval of final version of submitted manuscript; all authors agree to ensure any questions related to the work are appropriately resolved; Feng P, Wang ZD, Liu JG and Pan JJ contributed manuscript editing.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Jing Pan, MD, Associate Chief Physician, Department of Radiology, PLA Rocket Force Characteristic Medical Center, No. 16 Xinwai Street, Beijing 100088, China. panjingjing3969@sina.com
Received: February 13, 2021 Peer-review started: February 13, 2021 First decision: May 4, 2021 Revised: May 11, 2021 Accepted: August 19, 2021 Article in press: August 19, 2021 Published online: November 27, 2021 Processing time: 286 Days and 15.8 Hours
Abstract
Pancreatic head carcinoma (PHC) is one of the common gastrointestinal malignancies with a high morbidity and poor prognosis. At present, radical surgery is still the curative treatment for PHC. However, in clinical practice, the actual R0 resection rate, the local recurrence rate, and the prognosis of PHC are unsatisfactory. Therefore, the concept of total mesopancreas excision (TMpE) is proposed to achieve R0 resection. Although there have various controversies and discussions on the definition, the range of excision, and clinical prognosis of TMpE, the concept of TMpE can effectively increase the R0 resection rate, reduce the local recurrence rate, and improve the prognosis of PHC. Imaging is of importance in preoperative examination for PHC; however, traditional imaging assessment of PHC does not focus on mesopancreas. This review discusses the application of medical imaging in TMpE for PHC, to provide more accurate preoperative evaluation, range of excision, and more valuable postoperative follow-up evaluation for TMpE through imaging. It is believed that with further extensive research and exploratory application of TMpE for PHC, large-sample and multicenter studies will be realized, thus providing reliable evidence for imaging evaluation.
Core tip: As a new concept of radical treatment for pancreatic head carcinoma, total mesopancreas excision requires removal of all tissues (including nerves, capillaries and lymph nodes) in the mesopancreas and has potential for achievement of R0 resection. Correspondingly, imaging evaluation should include all of the anatomical structures within the mesopancreas to achieve precise preoperative evaluation for surgical resection and meet the needs of postoperative follow-up.
