TY - CHAP M1 - Book, Section TI - Perspective on Pancreatic Neoplasms A1 - Evans, Douglas B. A2 - Zinner, Michael J. A2 - Ashley, Stanley W. A2 - Hines, O. Joe PY - 2019 T2 - Maingot's Abdominal Operations, 13e AB - Drs. Gajdos, McCarter, Edil, Paniccia, and Schulick provide an extremely comprehensive chapter on the evaluation and treatment of patients with cancer of the periampullary region and especially the pancreatic head (Chapter 73). ­Importantly, there has been a tremendous advance in both the understanding of the molecular biology of pancreatic cancer as well as our ability to accurately image the pancreas and periampullary region prior to surgery. Advances in computed tomography (CT) and magnetic resonance imaging (MRI) have allowed for accurate assessment of critically important tumor-vessel relationships. Such accurate assessment of the relevant anatomy is important for both pretreatment staging and for planning the operation, especially if vascular resection and reconstruction may be indicated. The ability to preoperatively classify patients as having resectable, borderline resectable, or locally advanced pancreatic cancer (LAPC) allows for optimal treatment sequencing (often including neoadjuvant therapy), the evaluation of patients for investigator-­initiated and cooperative group clinical trials, and the referral of patients to higher volume centers.1 Indeed, to the extent that outcome is improved for patients with localized disease at high-volume centers (by high-volume surgeons), patients will need to be accurately staged (CT imaging) and, when necessary, have biliary stents placed safely in order to facilitate referral to a specialty center. The ability to perform endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) biopsy will prevent diagnostic uncertainty and allow for medical oncology consultation and multidisciplinary care. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/10 UR - accesssurgery.mhmedical.com/content.aspx?aid=1160046035 ER -