Radical antegrade modular pancreatosplenectomy: Report of two cases and review of the literature

Abstract

Introduction. The radical antegrade modular pancreatosplenectomy (RAMPS) procedure was introduced as a modification of standard retrograde pancreatosplenectomy (SRPS). It was designed to establish a new surgical approach, with intension to increase possibility of achieving negative posterior (retroperitoneal) resection margin, as well as to provide complete N1 lymph node clearance. Outline of cases. We present two cases with diagnosed left-sided pancreatic tumors, who were surgically treated in our hepato-pancreato-biliary department. Both patients underwent posterior RAMPS procedure. Postoperative course was uneventful in both patients. Conclusion. RAMPS is a safe procedure because it provides complete vascular and bleeding control. It is a superior procedure in oncologic terms compared to SRPS, as it increases the rate of R0 resection, and provides larger number of lymph nodes harvested. Furthermore, RAMPS is associated with better overall survival.

Keywords

• pancreatic carcinoma
• left-sided pancreatic tumors
• distal pancreatectomy
• ramps