[Emphasizing Principles of Surgical Oncology in Minimally Invasive Surgery for Pancreatic Cancer]

Surgical resection remains the only potentially curative treatment for pancreatic cancer to date. However, pancreatic cancer surgery is also one of procedures carrying the highest risks among all malignant tumor surgeries, in terms of perioperative complications and long-term prognosis, posing a significant challenge to surgeons. In recent years, the centralization of pancreatic surgery in high-volume centers, advancements in surgical techniques, and improvements in perioperative management of pancreatic cancer resection have significantly reduced the incidence of perioperative complications and mortality. In addition, surgeons have begun exploring minimally invasive approaches, such as laparoscopic and robot-assisted surgeries, for radical resection of pancreatic cancer, aiming to reduce surgical trauma, accelerate patient recovery, and improve quality of life. The technical feasibility of minimally invasive approaches has been validated in multiple studies through comparisons of the perioperative safety of minimally invasive pancreatic resection with that of conventional open surgery. However, research on the long-term oncologic prognosis of minimally invasive surgery for pancreatic cancer remains limited, and controversy persists regarding the suitability of minimally invasive methods for radical resection of pancreatic cancer. Therefore, surgeons should adhere to the fundamental principles of surgical oncology, including en bloc resection and the no-touch isolation technique, when they perform minimally invasive pancreatic cancer surgery. Additionally, more comparative studies are warranted to determine whether minimally invasive pancreatic cancer surgery offers survival benefits in the long term. This review aims to provide an objective evaluation of the role of minimally invasive techniques in radical resection of pancreatic cancer, while cautioning against compromising the principles of surgical oncology in the pursuit of minimally invasive approaches.