Classic vs superior mesenteric artery first approach in cephalic duodenopancreatectomy for pancreatic cancer

Abstract

Background: Surgery is the only curative treatment for head pancreatic cancer. The actual technique is the cephalic duodenopancreatectomy. Nowadays exist two different approaches for the pancreas resection, the classical technique also known as the Whipple intervention and the Superior Mesenteric Artery first approach. The SMA first approach remove more tissue from the surrounding area of the SMA and seems to be a more oncological technique. We are in need of a study that compares the survival without recurrences, the margins resection and the complications in both techniques to establish the approach with more benefits for the patients. Objective: The aim of this study is to measure the disease-free time comparing the two different surgical techniques for pancreatic cancer. We will also evaluate the margins affectation and the early complications in each technique. Design: A randomized, single-blinded, controlled clinical trial that will be performed in the Hospital Universitari Josep Trueta of Girona within the Hepatic-biliary-pancreatic unit, in the General Surgery Service, from January 2018 to June 2025. Methods: 92 patients with head pancreatic tumor will be recruited with a consecutive method. This patients will be randomly placed in one of the two treatment groups, either WT or SMAfa. T-Student test will be used for statistical analysis of the primary objective. A chi-square test will analyse the secondary objectives with a confidence interval of 95%