The incidence of pancreatic cancer and premalignant pancreatic cystic neoplasms has increased dramatically during the past few decades.
1, 2 For these patients, surgery, often via a pancreatoduodenectomy (PD), offers the best chance for cure or prevention of malignant transformation. Despite a historically high postoperative mortality rate, this complex operation is now relatively safe, with a recent mortality rate near 1% at high-volume centers.
3 In parallel, more potent chemotherapy regimens have provided enhanced systemic control for patients with pancreatic ductal adenocarcinoma (PDAC).
4 Consequently, these developments have expanded surgical candidacy and enabled more aggressive operative techniques.
5, 6 All these advancements have finally brought the 5-year survival rate for PDAC into the double-digit territory (10%).
1 Taken together, the number of PDs and indications for this approach continue to increase, and an increasing proportion of post-PD patients are achieving long-term survival. …