Surgical managements of pancreatic cancer: current status and future directions
The prognosis of patients with pancreatic carcinoma is the poorest of all the digestive system cancers, and the managements are very challenging. Now the treatment mode of pancreatic carcinoma is converting into “MDT” from “surgery first”. Neoadjuvant therapy is advocated for borderline resectable pancreatic carcinoma so as to increase rates of R0 resection. The standard lymphadenectomy is recommended in routine clinical practice except in special clinical trials. Pancreatic fistula is the severest complication of pancreatoduodenectomy. There are no significant differences in relation of methods of pancreatoenteric anastomosis to the occurrence of postoperative pancreatic fistula, so the quality of the anatomosis and the technical skills should be emphasized in order to decrease the incidence of pancreatic fistula.