Pancreatic stump management following Pancreatico-duodenectomy- tertiary centre experience

Abstract

Currently, only a few patients with pancreatic cancer are candidates for surgical resection, the only potentially curative therapy. In most patients, accurate preoperative staging of periampullary and pancreatic cancer is achieved by multidetector CT with three dimensional reconstruction. A resectable tumour is characterized by lack of evidence of metastatic disease, a clear tissue (fat) plane between the tumour and visceral arteries (celiac axis and superior mesenteric artery), and less than or equal to 180-degree-circumferential involvement of the superior mesenteric vein-portal vein confluence.

Surgical resection remains the only potentially curative therapy for periampullary and pancreatic cancer. Only a few patients currently diagnosed with pancreatic cancer are candidates for curative resection Approaches for resection are based on tumour location and extent. Resection of right-sided tumours typically requires pancreaticoduodenectomy. In many instances, preoperative biliary decompression is unnecessary and may result in increased postoperative complications.