Pancreatic surgery in cancer patients: Post-surgical care

Pancreatic cancer, despite its low occurrence, is the tenth leading cause of cancer in the United States, but the fourth leading cause of cancerrelated deaths among men and women (Niederhuber et al., Abeloff's clinical oncology. 5th ed. Philadelphis: Saunders; 2014). Although there is no evidence linking pancreatic cancer to caffeine consumption, cholelithiasis, or diabetes mellitus, its occurrence increased steadily in recent years, possibly due to the increase in the prevalence of obesity, obesity-related health issues, aging population, and other unknown factors. The high mortality rate remains largely unchanged. Ductal adenocarcinoma and its variants account for the most pancreatic malignancies. High-quality imaging preoperatively is important in distinguishing between potential resectable and unresectable diseases. The National Comprehensive Cancer Network (NCCN) established clinical guidelines to assist clinicians in clinical decision-making regarding pancreatic cancer treatment. Those guidelines focus on the diagnosis and the treatment with systemic therapy, radiation therapy, and surgical resection. At a large-volume cancer center, the overall guiding principle in managing pancreatic cancer focuses on well-organized multidisciplinary teams. From multiphase imaging studies, surgery, medical oncology, interventional endoscopy, anesthesiology, dietitian, critical care team, nursing, caregivers, and all teams are critical in successfully managing this disease.