MANAGEMENT

SURGICAL RESECTION Only potentially curative treatment for patients with pancreatic cancer The resectability of malignant pancreatic tumors needs to be established Pancreatic masses are characterized – resectable, unresectable, or borderline resectable.

SURGICAL RESECTION Pancreaticoduodenectomy (whipple procedure) Distal pancreatectomy Total pancreatectomy

PANCREATICODUODENECTOMY (WHIPPLE PROCEDURE) Removal of the head and uncinate process of the pancreas, duodenum, proximal 6 in (15 cm) of jejunum, gallbladder, common bile duct, and distal stomach With anastomosis of the common hepatic duct and the remaining pancreas and stomach to the jejunum All share a common blood supply

PANCREATICODUODENECTOMY (WHIPPLE PROCEDURE) The Whipple procedure. Before the procedure(A). After the procedure; note the anastomosis of the hepatic duct and the remaining pancreas and stomach to the jejunum(B).

PANCREATICODUODENECTOMY (WHIPPLE PROCEDURE) Patients who will most likely benefit from this procedure have a tumor located in the head of the pancreas or the periampullary region

DISTAL PANCREATECTOMY May be an effective procedure for tumors located in the body and tail of the pancreas Isolation of the distal portion of the pancreas containing the tumor Resection of that segment Oversewing of the distal pancreatic duct

TOTAL PANCREATECTOMY Tumor involves the neck of the pancreas. – Either the tumor originates from the neck or is growing into the neck