Translateral retroperitoneal approach in radical surgery for pancreatic carcinoma.

Investigations of the lymphatic routes using dye during operations and histological studies on the resected specimen of the pancreas and autopsied cases with pancreatic carcinoma have led to the conclusion that the surgery should be performed more extensively to improve the results and should consist of a complete lymphatic excision surrounding the celiac axis and the trunk of the superior mesenteric artery including dissection of the nerve plexus and wide retroperitoneal dissection surrounding the pancreas, upwards to the level of adrenal glands, and downwards to the level of iliac bifurcation. A translateral retroperitoneal approach was found to be the most useful and safe method for such extended resection in patients with pancreatic carcinoma. Our radical procedure for pancreatic carcinoma is described herein.