Management of solid and cystic lesions of the pancreas

This comprehensive chapter on pancreatic tumors discusses multidisciplinary management of pancreatic adenocarcinoma, pancreatic neuroendocrine tumors, and pancreatic cystic neoplasms as well as less often encountered pathologies such as metastases to the pancreas and lymphoepithelial cysts. While pancreatic resection in general has become safer, the advent of advanced laparoscopic pancreatectomy might contribute to reducing operative morbidity further. Pancreatic cancer therapy today requires a multidisciplinary approach, and this chapter by expert pancreas medical oncologists allows surgeons to put pancreas cancer surgery into the context of chemotherapy and/or radiation therapy. With the widespread use of axial abdominal imaging, there has been a significant increase in the detection of pancreatic cystic lesions. The minimally invasive pancreatic surgeon will frequently be asked to manage these patients because removal of potentially premalignant or early-malignant cystic lesions with prophylactic intent makes these operations well suited for the lesser morbidities associated with a minimally invasive approach. Therefore, it is critical that the surgeon becomes very familiar with the work-up, indications for resection, and surgical approaches to managing these cystic lesions.