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NOT YET RECRUITING
NCT07547033
NA

Superior Mesenteric Artery First Versus Standard Approach in Pancreaticoduodenectomy

Sponsor: Assistance Publique - Hôpitaux de Paris

View on ClinicalTrials.gov

Summary

"Pancreatic cancer, especially pancreatic ductal adenocarcinoma, is one of the most serious and deadly cancers. Its outlook is very poor, with fewer than 10% of patients surviving five years after diagnosis. This is largely because the disease is often discovered at a late stage and because it frequently comes back even after surgery. When the tumor is located in the head of the pancreas, the only treatment that can potentially cure the disease is a major operation called a pancreaticoduodenectomy, also known as the Whipple procedure. This surgery is now safely performed in specialized hospitals, but it remains complex and carries a high risk of complications. Importantly, even after surgery, cancer cells often remain, leading to a high rate of local recurrence. A newer surgical technique, known as the "artery-first" approach, changes the order of the operation. By carefully exposing a major blood vessel near the pancreas at the beginning of the surgery, surgeons can better assess whether the tumor can be completely removed and can improve the precision of the operation. This research protocol aims to compare this artery-first technique with the standard surgical approach. The goal is to determine whether starting the operation by addressing the artery allows for more complete tumor removal and reduces the risk of cancer coming back in patients with pancreatic cancer of the head of the pancreas."

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

150

Start Date

2026-09-01

Completion Date

2031-09-01

Last Updated

2026-04-23

Healthy Volunteers

No

Interventions

PROCEDURE

SMA-first pancreaticoduodenectomy using either right posterior or anterior approach. SMA identified and isolated with peri-adventitial dissection before any irreversible section.

Before any irreversible gesture, the surgeon identifies and isolates the superior mesenteric artery and dissects nerve plexus and nodes on the right side up to the SMA origin (right posterior or anterior approach).

PROCEDURE

Conventional pancreaticoduodenectomy without prior isolation of the SMA; antero-posterior approach of the uncinate process after pancreatic section.

Conventional pancreaticoduodenectomy without prior isolation of the SMA; antero-posterior approach of the uncinate process after pancreatic section.

Locations (23)

CHU Amiens

Amiens, France

CHU Angers

Angers, France

CHU Besançon

Besançon, France

Hôpital Haut Lévêque

Bordeaux, France

Hôpital Estaing

Clermont-Ferrand, France

Hôpital François Mitterrand

Dijon, France

CHU Lille - Hôpital Claude Huriez

Lille, France

Hôpital Claude Huriez

Lille, France

CHU Dupuytren 1

Limoges, France

Centre Léon Bérard

Lyon, France

Hôpital de la Croix-Rousse

Lyon, France

Hôpital Saint Eloi

Montpellier, France

Hôpitaux de Brabois

Nancy, France

Chu Nantes

Nantes, France

Hôpital Ambroise Paré

Paris, France

Hôpital Beaujon

Paris, France

Hôpital Cochin

Paris, France

Hôpital de la Pitié Salpêtrière

Paris, France

Hôpital Charles-Nicolle

Rouen, France

CHU Strasbourg

Strasbourg, France

Hôpital Rangueil

Toulouse, France

Hôpital Paul Brousse

Villejuif, France

Institut Gustave Roussy

Villejuif, France