Table 1.
Comparison of margins reported in pancreaticoduodenectomy specimen
| Margin | CAP11 | RCPUK,14 Verbeke and Menon13 | Leeds Protocol/Verbeke et al0007,0012 | Anatomical-based mapping9/author's approach |
|---|---|---|---|---|
| SMAM/uncinate (retroperitoneal) margin | + | + | − | + |
| SMVM | − | + | − | + |
| Mediala | − | − | + | − |
| Posterior | − | + | + | + |
| PNM | + | + | + | + |
| BDM | + | + | + | + |
| Anterior | − | + | + | +/−c |
| Otherb | + | − | − | − |
+ margin reported.
− margin not reported.
‘Medial circumferential resection margin, the part of the surface of the pancreatic head that faces the superior mesenteric vessels’.12
The following description is available in CAP Cancer protocols. Pancreas (exocrine), 2012:11 ‘deep retroperitoneal posterior surface of the pancreas … recommend inking the posterior surface of the pancreas and submission of sections through the tumour at its closest approach to this surface’.
In the author's opinion, the anterior margin present in a pylorus-preserving pancreaticoduodenectomy and absent in a standard Whipple procedure.
BDM, Bile duct margin; CAP, College of American Pathologists; PNM, Pancreatic neck margin; RCPUK, The Royal College of Pathologists of United Kingdom; SMAM, Superior mesenteric artery margin; SMVM, Superior mesenteric vein margin.