[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-372978-105":59,"doc-detail-372978-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","most-oncological-pancreas-resections-must-consider-the-mesopancreas","Most oncological pancreas resections must consider the mesopancreas","","The study evaluates whether mesopancreas (MP) involvement is underestimated in localized, primary resectable ductal adenocarcinoma of the pancreatic head (PDAC) patients undergoing upfront pancreatoduodenectomy. CRM assessment and standardized analysis of MP infiltration were performed, comparing localized disease without medial vascular groove infiltration to advanced PDAC. MP infiltration remained high in localized cases and significantly affected dorsal resection status, with inferior R0CRM rates, supporting routine mesopancreatic excision and discussion of neoadjuvant options.",{"@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/most-oncological-pancreas-resections-must-consider-the-mesopancreas/372978/",{"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/most-oncological-pancreas-resections-must-consider-the-mesopancreas/372978.png","ImageObject",300,407,{"name":92,"@type":93},"Emma Wilson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",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 is the purpose of mesopancreatic excision (MPE) in PDAC surgery?","Question",{"text":113,"@type":114},"MPE aims to secure the integrity of dorsal and ventral resection margins by targeting mesopancreatic tissue during pancreatoduodenectomy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did the study group patients for analysis?",{"text":118,"@type":114},"Patients were subgrouped by infiltration status of the vascular groove, with localized disease (LOC) defined as true/primary resectable without cancerous infiltration into the medial vascular groove.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the results show about mesopancreas infiltration in localized PDAC?",{"text":122,"@type":114},"In LOC patients, MP infiltration remained high, but was significantly lower than in advanced PDAC. The MP infiltration status also significantly impacted dorsal CRM resection outcomes.","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},372978,1790626921,{"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":44,"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},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Safi et al. BMC Cancer (2025) 25:200  \n[https://doi.org/10.1186/s12885-025-13599-x](https://doi.org/10.1186/s12885-025-13599-x)  \nBMC Cancer  \n RESEARCH Open Access  \nMost oncological pancreas resections must consider the mesopancreas  \nS. A. Safi 1†, S. David 1†, L. Haeberle2, S. Vaghiri 1, T. Luedde3, C. Roderburg3, I. Esposito2, G. Fluegen 1† and  \nW. T. Knoefel 1*†  \nAbstract  \nBackground In preoperative staging for patients with a ductal adenocarcinoma of the pancreatic head (PDAC), resectability is anatomically characterized by the possible clearance of the medial vascular grove. Borderline resectable PDAC patients who retain an increased risk of infiltration to the portomesenteric system and/or arterial vasculate are candidates for neoadjuvant therapy. However, redefined pathological analysis revealed the dorsal resection margin to be similar at risk for R1 resection. Mesopancreatic excision (MPE) aims to secure the integrity of the dorsal and ventral resection margins. The existence of the mesopancreas (MP) is inevitable, since the pancreas is of a secondary retroperitoneal nature and the dorsal as well as ventral fascial coverings define the peripancreatic compartment anatomy. It remains unknown if the MP area is only infiltrated in high-risk PDAC patients or if MPE during pancreatoduodenectomy should be employed for localized PDAC patients as well.  \nMethods Patients who underwent upfront pancreatoduodenectomy were included. CRM evaluation and analysis ofthe MP was standardized in all patients. Patients were sub-grouped by the infiltration status of the vascular groove (localized disease: LOC) . In LOC patients there was evidently no cancerous infiltration into the medial vascular groove (true + primary resectable) .  \nResults Two hundred eighty-four consecutive patients who underwent pancreatoduodenectomy were included (169 LOC patients) . In LOC patients the MP infiltration rate remained high but was significantly lower when compared to advanced PDAC patients (MP +69. 2% vs. 83. 5%, p = 0.005) . In LOC patients, CRM resection status of the dorsal resection status remained significantly affected by the MP infiltration status (R0CRM– 80 . 5% vs. 62. 8%, p = 0.019) . Conclusion These important findings clearly show underestimated tumor extensions into the mesopancreas even in localized, primary resectable PDAC patients who are currently amenable for upfront resection. Synergistically to total mesorectal or mesocolic excision, which is applied to all stages of colorectal disease, MPE is justified in primary resectable patients as well. Therefore, MPE should be employed in all PDAC patients. Since the infiltration status of the mesopancreas was a significant factor for incomplete resection in primary resectable PDAC patients, neoadjuvant treatment options for must be discussed.  \nKeywords PDAC, Ductal adenocarcinoma of the pancreas, Pancreatic cancer, CRM, Mesopancreatic excision, Mesopancreas  \n\n| †S. A. Safi and S. David contributed equally to this work. |\n| --- |\n| †G. Fluegen and W. T. Knoefel shared senior authorship. |\n\n*Correspondence:  \nW. T. Knoefel[knoefel@hhu.de](knoefel@hhu.de)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the","cbCaitZsAOUh42wf","https://ap.wps.com/l/cbCaitZsAOUh42wf","pdf",1515385,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What is the purpose of mesopancreatic excision (MPE) in PDAC surgery?\",\"answer\":\"MPE aims to secure the integrity of dorsal and ventral resection margins by targeting mesopancreatic tissue during pancreatoduodenectomy.\"},{\"question\":\"How did the study group patients for analysis?\",\"answer\":\"Patients were subgrouped by infiltration status of the vascular groove, with localized disease (LOC) defined as true/primary resectable without cancerous infiltration into the medial vascular groove.\"},{\"question\":\"What did the results show about mesopancreas infiltration in localized PDAC?\",\"answer\":\"In LOC patients, MP infiltration remained high, but was significantly lower than in advanced PDAC. The MP infiltration status also significantly impacted dorsal CRM resection outcomes.\"}]","Most oncological pancreas resections must consider the mesopancreas | PDF",1790196121,23]