Effect Comparison of Different Approaches for Pancreaticoduodenectomy in the Treatment of Pancreatic Head Cancer

QIN Jingyi; LI Jianjun; ZHANG Kaiming; WANG Huifeng

doi:10.3969/j.issn.1004-437X.2025.24.009

Abstract：Objective To investigate the clinical efficacy of different approaches for pancreaticoduodenectomy(PD)in the treatment of pancreatic head cancer.Methods Data of 95 patients with pancreatic head cancer who completed PD treatment in the hospital from May 2019 to May 2024 were collected.According to different PD approaches,they were divided into a standard approach group(47 cases,standard approach down PD)and an anterior approach group(48 cases,anterior approach down PD).The relevant indexes of operation,postoperative pathological examination,recurrence at 6 months follow-up were compared between the two groups,and postoperative complications were recorded.Results The intraoperative bleeding volume in the anterior approach group was less than that in the standard approach group(P＜0.05).The number of lymph node dissections in the anterior approach group was higher than that in the standard approach group,and the R0 resection rate was higher than that in the standard approach group(P＜0.05).There was no significant difference in the incidence of complications between the groups(P＞0.05).At the 6-month follow-up,there was no significant difference in recurrence rate between the anterior approach group and the standard approach group(P＞0.05).Conclusion The safety of standard approach PD and anterior approach PD in the treatment of pancreatic head cancer is comparable,with similar surgical time and postoperative recovery.However,compared with the standard approach,the anterior approach PD has less intraoperative bleeding and can improve the number of lymph node dissections and R0 resection rate.