"Five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in laparoscopic pancreaticoduodenectomy

Figure 1 Visualization of the surgical fields after the completion of each surgical step via the five-step four-zone method. A: The common hepatic artery was exposed and suspended along the No. 8a lymph node; B: The surgical field after the dissection of the upper zone of the hepatic artery (HA)/portal vein (PV) axis; C: The surgical field after the dissection of the left zone of the HA/PV axis; D: The surgical field after the dissection of the right zone of the HA/PV axis; E: The surgical field after the dissection of the lower zone of the HA/PV axis; F: The surgical field of the hepatic hilum region after the completion of the dissection. LN 8a: No. 8a lymph node; CHA: Common hepatic artery; GDA: Gastroduodenal artery; RHA: Right hepatic artey; PHA: Proper hepatic artery; LN: Lymph node; LGA: Left gastric artery; CHD: Common hepatic duct; IVC: Inferior vena cave.

Figure 2 Correlations between body mass index, total bilirubin level, prothrombin time, blood loss and lymph node dissection time. A: Body mass index; B: Total bilirubin; C: Prothrombin time; D: Blood loss. BMI: Body mass index; TBIL: Total bilirubin; PT: Prothrombin time.

Figure 3 The effects of body mass index and total bilirubin on lymph node dissection time. A: Body mass index; B: Total bilirubin. ^aP < 0.05. BMI: Body mass index; TBIL: Total bilirubin.