[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-332001-105":59,"doc-detail-332001-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","defining-distal-splenopancreatectomy-by-the-mesopancreas","Defining distal splenopancreatectomy by the mesopancreas","","Study assesses whether mesopancreatic (MP) tissue is infiltrated in distal pancreatic ductal adenocarcinoma (dPDAC) and whether MP infiltration status influences circumferential resection margin (CRM) clearance, affecting recurrence and survival. Background notes that CRM staging increased dorsal-margin R1 resections for pancreatic head tumors, leading to promoted mesopancreatic excision (MPE) during pancreatoduodenectomy. Clinicopathologic evaluation compared dPDAC outcomes and a collective hPDAC cohort receiving MPE.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/defining-distal-splenopancreatectomy-by-the-mesopancreas/332001/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/defining-distal-splenopancreatectomy-by-the-mesopancreas/332001.png","ImageObject",300,407,{"name":92,"@type":93},"Ava Thompson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study aim regarding the mesopancreas in dPDAC?","Question",{"text":113,"@type":114},"To histopathologically analyze mesopancreatic (MP) infiltration in distal pancreatic (tail/body) carcinomas and determine how resection margin clearance influences recurrence and survival.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was CRM and specimen evaluation performed?",{"text":118,"@type":114},"CRM assessment followed a standardized approach and specimens were examined according to the Leeds pathology protocol (LEEPP), with MP area evaluated for cancerous infiltration.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the results show about MP infiltration in dPDAC?",{"text":122,"@type":114},"In 75.4% of dPDAC patients, MP fat was infiltrated by vital tumor cells, while MP infiltration status did not correlate with CRM implemented resection status in dPDAC patients.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},332001,1790465386,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":105,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1649267921044,"https://us-avatar.wpscdn.com/avatar/1800007509477c92dfb?_k=1786009248482753345","Langenbeck's Archives of Surgery (2024) 409:127 [https://doi.org/10.1007/s00423-024-03320-0](https://doi.org/10.1007/s00423-024-03320-0)  \nDefining distal splenopancreatectomy by the mesopancreas  \nS.‑A. Safi1 · A. Alexander1 · W. Neuhuber2 · L. Haeberle3 · A. Rehders1 · T. Luedde4 · I. Esposito3 · G. Fluegen1 ·  \nW. T. Knoefel1  \nReceived: 16 January 2024 / Accepted: 10 April 2024 © The Author(s) 2024  \nAbstract  \nBackground The implementation of the pathologic CRM (circumferential resection margin) staging system for pancreatic head ductal adenocarcinomas (hPDAC) resulted in a dramatic increase of R1 resections at the dorsal resection margin, presumably because of the high rate of mesopancreatic fat (MP) infiltration. Therefore, mesopancreatic excision (MPE) during pancreatoduodenectomy has recently been promoted and has demonstrated better local disease control, fueling the discussion of neoadjuvant downsizing regimes in MP + patients. However, it is unknown to what extent the MP is infiltrated in patients with distal pancreatic (tail/body) carcinomas (dPDAC) . It is also unknown if the MP infiltration status affects surgical margin control in distal pancreatectomy (DP). The aim of our study was to histopathologically analyze MP infiltration and elucidate the influence of resection margin clearance on recurrence and survival in patients with dPDAC. Furthermore, the results were compared to a collective receiving MPE for hPDAC.  \nMethod Clinicopathological and survival parameters of 295 consecutive patients who underwent surgery for PDAC (n = 63 dPDAC and n = 232 hPDAC) were evaluated. The CRM evaluation was performed in a standardized fashion and the specimens were examined according to the Leeds pathology protocol (LEEPP). The MP area was histopathologically evaluated for cancerous infiltration.  \nResults In 75.4% ofdPDAC patients the MP fat was infiltrated by vital tumor cells. The rates of MP infiltration and R0CRM– resections were similar between dPDAC and hPDAC patients (p = 0.497 and 0.453 respectively) . MP– infiltration status did not correlate with CRM implemented resection status in dPDAC patients (p = 0.348) . In overall survival analysis, resection status and MP status remained prognostic factors for survival. In follow up analysis. surgical margin clearance in dPDAC patients was associated with a significant improvement in local recurrence rates (5.2% in R0CRM– resected vs. 33.3 in R1/ R0CRM + resected, p = 0.002) .  \nConclusion While resection margin status was not affected by the MP status in dPDAC patients, the high MP infiltration rate, as well as improved survival in MP– dPDAC patients after R0CRM– resection, justify mesopancreatic excision during splenopancreatectomy. Larger scale studies are urgently needed to validate our results and to study the effect on neoadjuvant treatment in dPDAC patients.  \nKeywords PDAC · Ductal adenocarcinoma of the pancreas · Pancreatic cancer · CRM · Mesopancreatic excision · Survival outcome · Peripancreatic tissue · Distal pancreatectomy  \nS.-A. Safi, A. Alexander, G. Fluegen and W. T. Knoefel contributed equally to this work.  \n* W. T. Knoefel[knoefel@hhu.de](knoefel@hhu.de)  \n1 Departments of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5,  \n40225 Duesseldorf, Germany  \n2 Institute of Anatomy I, Friedrich-Alexander University Erlangen-Nuremberg, Universitätsstr. 1, Erlangen, Germany  \nAbbreviations  \nCHA Common hepatic artery  \nCRM Circumferential resection margin  \n3 Institute of Pathology, Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5,  \n40225 Duesseldorf, Germany  \n4 Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany  \ndPDAC  \nDM  \nFFPE  \nhPDAC  \nILR  \nIMV  \nL  \nLEEPP  \nMP  \nMPE  \nPD  \nPn  \nPV/SMV  \nSA  \nSMA  \nSV  \nUICC  \nV  \nDistal ductal adenocarcinoma of the pancreas (body/ta","cbCaiufnapzutD3S","https://ap.wps.com/l/cbCaiufnapzutD3S","pdf",1741459,"English","# Abstract\n## Background\n## Method\n## Results\n## Conclusion\n# Introduction\n## Pathology protocol and CRM staging\n## Rationale for mesopancreatic excision","[{\"question\":\"What was the study aim regarding the mesopancreas in dPDAC?\",\"answer\":\"To histopathologically analyze mesopancreatic (MP) infiltration in distal pancreatic (tail/body) carcinomas and determine how resection margin clearance influences recurrence and survival.\"},{\"question\":\"How was CRM and specimen evaluation performed?\",\"answer\":\"CRM assessment followed a standardized approach and specimens were examined according to the Leeds pathology protocol (LEEPP), with MP area evaluated for cancerous infiltration.\"},{\"question\":\"What did the results show about MP infiltration in dPDAC?\",\"answer\":\"In 75.4% of dPDAC patients, MP fat was infiltrated by vital tumor cells, while MP infiltration status did not correlate with CRM implemented resection status in dPDAC patients.\"}]","Defining distal splenopancreatectomy by the mesopancreas | PDF",1789996245,28]