Proximal Resection

Tina W.F. Yen, Douglas B. Evans Introduction

Kausch was the first to describe a pancreatoduodenectomy, but Whipple, who described pancreaticoduodenectomy for pancreatic head adenocarcinoma in 1935 as a two-stage operation, has largely been given credit by the eponym. Waugh and Clagett modified the operation in 1946 to its current one-stage procedure. The operation involves the en bloc removal of the pancreatic head, duodenum, gallbladder, and bile duct, with the gastric antrum. Traverso and Longmire popularized the pylorus-preserving technique. The goal of the operation is complete removal of the neoplasm (R0 resection). There are no data to support debulking (R2 resection) in patients with adenocarcinoma of the pancreas. Therefore, the preoperative assessment of local tumor resectability is of critical importance.

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