Total mesopancreas excision enhances surgical outcomes in pancreatoduodenectomy.

In a systematic review of 738 pancreatic head cancer patients, total mesopancreas excision (TMPE) significantly increased R0 resection rates (RR 1.24) and reduced overall (RR 0.53) and local recurrence rates (RR 0.39) compared to standard pancreatoduodenectomy. TMPE also reduced blood loss (MD -143.70 ml) and enhanced lymph node harvest (MD 7.27 nodes), all while showing no significant difference in postoperative complications or mortality. These findings suggest TMPE offers an effective approach to improving surgical outcomes.