Pancreatic cancer is a global health problem because of its high mortality. Local recurrence, rather than metastatic disease, is considered the primary reason for poor prognosis of these patients. Although a consensus has not been established, Cephalic duodenopancreatectomy with “total mesopancreas excision” or right retro-portal lamina resection is suggested to decrease local recurrence, improving patient survival. The right retro-portal lamina was first described in 1959, its anatomical description does not appear in classic anatomical textbooks. The following work aims to perform an anatomical and histological study of the right retro-portal lamina.
A descriptive anatomical study of 30 adult cadavers, fixed in formaldehyde-based solution was performed. The presence of the lamina, limits, dimensions, and macro- and microscopic content was registered.
Right retro-portal lamina was found in 100% of the cases. Its limits were the pancreas uncinate process to the right and the vascular sheath of the superior mesenteric artery to the left. Its dimensions were an average of 20 mm long, 17 mm wide and 3 mm thick. The inferior pancreatic-duodenal artery was identified in 26.6% of the cases. Pancreatic and adipose tissue, as well as vascular and nervous elements, were identified.
The right retro-portal lamina is a constant connective-vasculo-nervous formation. It can be identified with relative ease given its constant insertions. It contains vascular (especially lymphatic) and nervous elements, which argues in favor of its resection in order to avoid local recurrences at this level.