Extended lymph node dissection for pancreatic head carcinoma: controversy and update

Lymph node dissection was the key procedure of pancreatic surgery. The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate. However, there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure. It was still a controversial topic considering lymph node dissection. To review the shortcomings of previous rando-mized controlled trials (RCT), this article combined the experience of new techniques in pancreatic surgery, which are developing rapidly in recent years, and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL). Therefore, the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed, which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice. Key words: Pancreatic cancer; Extended lymph node dissection; Radical resection of retroperitoneal lipo-lymphatic Layer