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During pancreaticoduodenectomy, early neck division may be inadequate, particularly in cases of replaced or accessory right hepatic artery (RHA) or diffuse intraductal papillary and mucinous neoplasm (IPMN) or when invasion of superior mesenteric artery is suspected. Modification of the technique of pancreaticoduodenectomy with dissection of the superior mesenteric vessels performed from behind...