Retroperitoneal margin of the pancreaticoduodenectomy specimen: anatomic mapping for the surgical pathologist |
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Authors: | Mahmoud A Khalifa Vlad Maksymov and Corwyn Rowsell |
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Institution: | (1) Department of Pathology, Sunnybrook Health Sciences Center, 2075 Bayview Avenue, Room E-400, Toronto, ON, M4N 3M5, Canada;(2) Department of Pathology, Memorial University of Newfoundland, St. John’s, Canada |
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Abstract: | Surgical margin status of the pancreaticoduodenectomy specimen is an independent predictor of survival in patients with pancreatic
head cancer. Although most surgical pathologists are familiar with the protocols for grossing and evaluation of the various
margins of the specimen, the currently prevailing definitions of the retroperitoneal surgical margin minimize the fact that
this margin is actually a combination of surfaces of different anatomical structures. The unfamiliarity with its detailed
anatomy often creates communication gaps when the pathologic findings are presented to other members of the multidisciplinary
team. The following discussion is the collective opinion of hepato-pancreato-biliary pathologists in two tertiary care Canadian
medical centers in this field. It describes the authors’ proposed nomenclature and landmarks for anatomic mapping of the retroperitoneal
margin of the pancreaticoduodenectomy resected specimen. Increasing familiarity with the subtleties of the retroperitoneal
margin is expected to improve communication and sets the stage for future quality improvement initiatives and translational
research in the multidisciplinary setting. |
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Keywords: | Surgical margins Whipple’ s specimen Pancreaticoduodenectomy Anatomy Pancreas |
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