Surgical techniques for improving outcomes in pancreatic ductal adenocarcinoma.
Pancreatic ductal adenocarcinoma is a devastating disease with extremely poor survival despite patients undergoing potentially curative resections and improvements in chemotherapeutic agents. Surgery for operable cancer in the head of the pancreas typically involves an open pancreaticoduodenectomy with a post-operative median survival of 21 months. Newer surgical techniques, however, aim to improve patient outcomes in terms of both their hospital experience and better oncological results. This article focuses on the evidence to date for some of these surgical techniques including laparoscopic and robotic surgery, the no-touch technique, venous and arterial resection, intra-operative radiofrequency ablation and intra-operative irreversible electroporation. With the increased use of these techniques we hope to see better quality of life and survival for these patients.
Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital campus, Du Cane Road, London, W12 0HS, UK.
Tamara Mh
TM
Gall
Zoe
Z
Thompson
Eoin P
EP
Dinneen
Mikael
M
Sodergren
Madhava
M
Pai
Adam E
AE
Frampton
Long R
LR
Jiao
D000230:Adenocarcinoma / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D053672:Electrochemotherapy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011788:Quality of Life; D012371:Robotics / Q000379:methods; D016896:Treatment Outcome