Advances in surgery for pancreatic cancer

Over the past 135 years, the field of pancreatic surgery for treatment of pancreatic malignancies has been a challenge to the surgical community. Originally filled with unacceptably high morbidity and mortality, these obstacles have been overcome through the work of numerous great surgeons in recent decades. Today, despite the improved safety of operating on the pancreas, patients still suffer from high rates of malignant recurrence and poor overall survival. Recent advances in pancreatic surgery aim to further improve the morbidity of these operations while increasing the number of patients who are both candidates for surgical resection and those who receive complete resections. This review focuses on recent literature describing the pros and cons of minimally invasive approaches to pancreatic surgery and the risks and benefits of vascular reconstruction to improve resectability. Both topics are currently debated amongst pancreatic surgeons and this article summarizes the varied viewpoints and their impact on outcomes in pancreas cancer surgery.