Operative principles in managing patients with borderline resectable pancreas cancer

Abstract

Borderline resectable pancreas cancer is a complex and challenging disease entity that requires a multidisciplinary team for successful management. The role of the surgeon is to determine the appropriateness and optimal timing of surgical resection, and when feasible, to perform a margin-negative resection and regional lymphadenectomy with minimal morbidity. This chapter discusses considerations regarding the timing of surgery, the basic principles of distal pancreatectomy and pancreaticoduodenectomy for pancreatic adenocarcinoma, and variations in surgical technique and perioperative care that have been investigated prospectively with the aim of minimizing morbidity.