ABSTRACT
Even though surgical resection remains the only potentially curative treatment for adenocarcinoma of the pancreas, only 10-20% of patients are candidates for pancreatic resection.1,2 This low resectability rate reflects the advanced stage of disease at the time of diagnosis, with almost 50% of patients having distant spread of tumor and approximately one-third manifesting locally advanced disease. Most agree that distant metastases constitute an absolute contraindication for pancreatic resection. Locally advanced disease, which includes regional adenopathy and/or major vascular involvement, may also preclude curative resection. For many, the inability to dissect the pancreas from the portal vein (PV) or superior mesenteric vein (SMV) has historically been a contraindication for resection of patients with adenocarcinoma of the pancreas. Not infrequently, isolated local invasion of the PV or SMV may be the only obstacle to resection.
