Medial retraction of the SMPV confluence allows identification of the SMA lateral to the SMPV confluence and facilitates dissection of the pancreatic head and soft tissues off of the right lateral wall of the proximal SMA. Failure to fully mobilize the SMPV confluence and expose the SMA usually results in a positive resection margin due to incomplete removal of the uncinate process and the mesenteric soft tissue adjacent to the SMA.
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