Progress and assessment of total mesopancreas excision of pancreas

As no fiber sheath covered, mesopancreas is considered to be different from mesocolon and mesorectum. Though amount of lymphatic, nervous, vascular and fat tissues are consisted in this structure, the margin and range are still controversial in the clinical practice. Only a few clinical reports show a higher R0resection rate with the procedure of total mesopancreas excision (TMpE), but most of the studies are single-centered and retrospective, from which we could not assess the outcome improvement for the patients undergoing TMpE. More-over, the difference between the ranges of TMpE and ever-used extended excision or lymphectomy should be further evaluated. More anatomical and clinical studies are needed to standardize the operation range in order to benefit the patients.