Pancreatic head cancer - Current surgery techniques.

Area of Science:

• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Pancreatic head cancer is a highly fatal malignancy with limited curative options.
• Surgery is the only potential long-term cure, but it carries significant risks.
• Advances in surgical techniques have improved outcomes, with 5-year survival rates nearing 30% post-resection and adjuvant chemotherapy.

Purpose of the Study:

• To present current data on surgical management of pancreatic head cancer.
• To define resectable and borderline resectable tumors and the concept of the mesopancreas.
• To review novel surgical techniques aimed at improving pancreaticoduodenectomy (PD) outcomes.

Main Methods:

• Review of current literature and data on pancreatic head cancer surgery.
• Discussion of recommended lymphadenectomy extent and resection margins.
• Presentation of various surgical approaches for pancreaticoduodenectomy.

Main Results:

• Surgical resection combined with adjuvant chemotherapy offers a 5-year survival approaching 30%.
• Clear definitions for resectable/borderline resectable tumors and the mesopancreas are crucial.
• Several advanced surgical techniques are proposed to enhance PD efficacy.

Conclusions:

• Surgical advancements have significantly improved survival for pancreatic head cancer.
• Standardization of lymphadenectomy, resection margins, and tumor definition is essential.
• Innovative surgical approaches like "artery first" and "mesopancreas first" show promise for better patient outcomes.