الفهرس 
Lower Extremity Venous AnatomyOnly 14 pages are availabe for public view
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Abstract
Abstract
Introduction: pancreatic cancer is one of the most lethal human cancers and continues to be a major unsolved health problem at the start of the 21st century. It accounts for 3% of new cancer cases per annum, yet it is the fourth leading cause of cancer-related death in Western countries.
Surgical resection is the only potentially curative technique for managing pancreatic cancer although 80% of patients present with disease that cannot be cured with surgical resection. Surgical resection has the greatest potential to offer prolonged disease-free survival and therefore an overall survival benefit across all stages.
Borderline resectable tumor was defined as pancreatic ductal adenocarcinoma with an abutment (tumor involvement, 180° of the circumference vessel) of the superior mesenteric vein or portal vein and of the superior mesenteric vein or hepatic artery. Short-segment encasement/occlusion of the superior mesenteric vein or portal vein amenable to vascular resection and reconstruction was considered as borderline resectable disease as well.
Objectives: the aim of this essay is to review debatable points regarding the operative management of pancreatic head cancer
Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2017.
Summary: pancreatic cancer is the 12th most common cancer worldwide, with around 338,000 new cases diagnosed with the disease in 2012 (2% of the total number cases) .Preoperative biliary drainge may be accomplished by surgical, radiologic, or endoscopic techniques ERCP is generally considered safer, less invasive, and is preferred for most patients when technically feasible. Pancreaticoduodenectomy (PD) is the procedure of choice for pancreatic ductal adenocarcinoma (PDAC). Extended surgery has improved resectability followed by promising outcomes in some retrospective studies; however, there was no reliable report in prospective studies that shows increased long-term survival. Macroscopic (R1) and microscopic (R0) complete tumor resection can be achieved in patients with locally advanced disease by extended pancreaticoduodenectomy. The concept of borderline resectable pancreatic cancer (BRPC) is a relatively recent, but important development in the treatment of pancreatic cancer. The precise definition of BRPC remains somewhat subjective. While the various definitions have similar core components, differences exist regarding the precise details of vascular involvement. Minimally invasive pancreaticoduodenectomy (MIPD) is not only technically feasible and safe in pancreatic cancer but may also provide advantages such as shorter length of hospital stay and quicker recovery.