Role of the total mesopancreas excision in the surgical radical treatment of pancreatic head cancer

In the last five years many authors, both Europeans, and Asiatic have emphasized the role of extended lymph node dissection and resection of retropancreatic tissue as the most significant technical options to achieve a radical intent in Duodenopancreatectomy for cancer. The scientific literature has thus given much importance to the removal of mesopancreas that, according to many authors, is a well-defined anatomical entities and most frequent site of recurrence after duodenopancreatectomy. The aim of this work is to analyze, in this regard, the literature data and finally make our contribution in favor of excision of mesopancreas that we have always realized, in the last six years of our experience, and that we believe underlie the reduction in the incidence of residual disease (R1) after duodenopancreatectomy.