Pancreatoduodenectomy

Alessandro Condivilla of Bologna first attempted a resection of the head of the pan creas in 1898, but several decades of further trial-and-error attempts ensued before the prototype procedure of pancreatoduodenectomy (PD) was established by Whipple in 1935. In the half-century following that landmark, refinements of surgical technique, including pancreatico-and bilio-entero anastomosis as well as develop ment of new technology to support perioperative management and patient care have contributed to the decrease in mortality and morbidity rates for obstructive jaundice and pancreatic fistula. The improvement in mortality and morbidity rates associated with PD has led to an increase in the number of patients undergoing the procedure and in the number of institutions performing it. Indications for PD have also been expanded. In the early years after PD was established as a viable procedure, periampullary carcinoma was the most common indication; now PD is indicated for a number of benign and malignant diseases. Some surgeons believe that PD is the procedure of choice for certain types of chronic pancreatitis, pancreatico-biliary maljunction, and pancreatic and duodenal trauma. Other surgeons have reported the necessity of PD for lymph node dissection of gallbladder carcinoma. Consequently, the basic procedure has been greatly modi fied to accommodate the specific conditions of each disease. For patients with malig nancy, extended procedures have been developed to improve the curative resection rate and ensure complete lymph node dissection.

As Professor Owen H Wangensteen, one of the greatest academic surgeons of the 20th century, said: ?You are a true surgeon from the moment you are able to deal with your complications.? Prompt and accurate diagnosis, as well as effective treatment, of surgical complications is one of the most important elements of surgical practice. This is today more important than at any other time, since over the last 20 years we have witnessed the development of new surgical sub-specialties, the performing of complicated operations in very challenging patients, the introduction of new technologies in surgical practice and, last but not least, an increasing interest in monitoring the quality, medico-legal implications, and ethical dimensions of surgical practice and malpractice. As surgical complications have been presented briefly and sporadically in various books and only as a small part of chapters dealing with surgical techniques, there is a pressing need for a modern textbook dealing with the diagnosis, treatment, auditing, medico-legal implications and ethical problems related to surgical complications.Written by internationally known authors, the chapters deal with both the general issues regarding the surgical complications and the specific issues related to each surgical specialty. Each chapter includes: clinical presentation; diagnosis (clinical, laboratory investigations, imaging); treatment (conservative, surgical); and outcome.

This textbook provides a practically applicable resource for understanding the surgical oncology management of pancreatic cancer. It discusses relevant aspects of anatomy and pathophysiology along with the latest diagnostic techniques. Insightful descriptions are then provided detailing how to perform critical surgical procedures when treating these patients. Relevant perioperative management strategies and emerging themes in cancer biology critical to understanding and treating the disease are also described. The need for cross-discipline collaboration to facilitate and enhance innovation within the discipline is reinforced throughout the text. Each chapter presents the relevant current clinical standards along with areas of controversy in both research and clinical practice within “pearls and pitfalls” sections. Textbook of Pancreatic Cancer: Principles and Practice of Surgical Oncology is a detailed work covering the basic material important to trainees as well as advanced curriculum for established specialists in the field from a multi-disciplinary perspective. Therefore, it is crucial resource for all practicing and trainee professionals who encounter these patients in their day-to-day clinical practice.

This book comprehensively discusses advanced surgical techniques for pancreatic cancers, including open, laparoscopic and robotic-assisted surgery, as well as palliative surgery and total meso-pancreas excision. It also features high-resolution illustrations taken from selected clinical cases to enhance the descriptions of the surgical procedures. Providing details of technical issues and commenting on the outcome, it a timely reference resource for pancreatic surgeons, pancreatic physicians, and interns interested in pancreatic cancer surgery.

This book is intended for medical students and surgical trainees such as surgical residents and fellows. It provides a practical preparation guide for common surgical procedures. Operations are divided into twelve sections that cover commonly performed general surgery operations such as bariatric, breast, cardiothoracic, colorectal, minimally invasive, and more. The chapters included in these sections aim to assist residents and fellows in facilitating memorization of the operation sequence and movements required to perform a given task. It will also help enhance skill development in the operating room. Written by residents and highly experienced attending surgeons, Mental Conditioning to Perform Common Operations in General Surgery Training: A Systematic Approach to Expediting Skill Acquisition and Maintaining Dexterity in Performance provides a comprehensive systematic approach to performing surgical procedures.

Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

Frontiers in Oncology is delighted to present the Methods in series of article collections. Methods in Surgical Oncology will publish high-quality methodical studies on key topics in the field. It aims to highlight recent advances in the field, whilst emphasizing important directions and new possibilities for future inquiries. The Methods in Surgical Oncology collection aims to highlight the latest experimental techniques and methods used to investigate fundamental questions in Surgical Oncology. Review Articles or Opinion Articles on methodologies or applications including the advantages and limitations of each are welcome. This Research Topic includes technologies and up-to-date methods which help aim to help advance science.