Journal
SCANDINAVIAN JOURNAL OF SURGERY
Volume 109, Issue 1, Pages 18-28Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1457496919900413
Keywords
Pancreatic ductal adenocarcinoma; neoadjuvant therapy; neoadjuvant chemotherapy; neoadjuvant chemoradiotherapy; pancreatectomy; borderline resectable; locally advanced; FOLFIRINOX; gemcitabine; nab-paclitaxel
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Background and Aims: It has become clear that vein resection and reconstruction for pancreatic ductal adenocarcinoma (PDAC) is the standard of care as supported by multiple guidelines. However, resection of large peri-pancreatic arteries remains debatable. Materials and Methods: This review examines the current state of vascular resection with curative intent for PDAC in the last 5 years. Herein, we consider venous (superior mesenteric vein, portal vein), as well as arterial (superior mesenteric artery, celiac trunk, hepatic artery) resection or both with or without reconstruction. Results: Improvement of multidrug chemotherapy has revolutionized care for PDAC that should shift traditional surgical thinking from an anatomical classification of resectability to a prognostic and biological classification. Conclusion: The present review gives an overview on the results of pancreatectomy associated with vascular resection, with consideration of new perspectives offered by the availability of better systemic therapies.
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