The “Superior Mesenteric Artery First” Approach Shows Comparable Outcomes to Conventional Approach in Pancreaticoduodenectomy

A comparative study evaluated the short-term and long-term outcomes of the “superior mesenteric artery first” (SMA-first) approach versus the conventional approach in pancreatic ductal adenocarcinoma (PDAC) patients undergoing laparoscopic pancreaticoduodenectomy. The SMA-first approach demonstrated a higher number of harvested lymph nodes and a lower involvement of the superior mesenteric artery (SMA) margin. No significant differences were observed in surgical complications, mortality, or overall survival between the two groups. The study concludes that the SMA-first approach is safe and feasible for PDAC patients, with comparable outcomes to the conventional approach.