Surgery for Pancreatic Cancer

Surgery for pancreatic cancer has undergone dramatic technical improvements over the past few decades. These developments have been driven by several factors beginning with the need to reduce postoperative mortality rates to less than 5% by centralization of pancreatic cancer surgery into major centers. Secondly the improvement on long-term survival has resulted in many more patients being offered resectional surgery. Thirdly the realization that neoadjuvant chemotherapy can actually promote resection in locally advanced borderline and unresectable cancers has further stimulated the development of newer techniques for routine venous and arterial resection, and fundamentally newer techniques such as the artery first and triangle operations.