Abstract：
Pancreatic resection for pancreatic ductal adenocarcinoma (PDAC) is one of the most complex procedures in abdominal surgery due to the technical and oncological challenges given by its local aggressive growth. The improvement of new multidrug chemotherapy regimens and surgical techniques has increased the caseload of \"borderline resectable\" (BR) or even \"locally advanced\" (LA) PDAC candidates for surgical resection. As a result, the increased heterogeneity of surgical scenarios has made it essential to utilize a tailored surgical strategy for each individual case. Notably, the strategy employed to approach and assess the peripancreatic vessels should be weighted according to tumor\'s location and the site of suspected vascular infiltration. The aim of this paper is to describe the open surgical approach for \"BR\" or \"LA\" PDAC used at our Institution and summarizes a \"step-up approach\" to manage vascular infiltration.
摘要：
胰腺导管腺癌（PDAC）的胰腺切除术是腹部手术中最复杂的手术之一，因为其局部积极生长带来了技术和肿瘤方面的挑战。新的多药化疗方案和手术技术的改进增加了用于手术切除的“临界可切除”（BR）甚至“局部晚期”（LA）PDAC候选人的病例数。因此,手术方案的异质性增加,因此必须针对每个病例采用量身定制的手术策略.值得注意的是,根据肿瘤的位置和疑似血管浸润的部位，采用的方法对胰周血管的穿刺和评估进行加权。本文的目的是描述我们机构使用的“BR”或“LA”PDAC的开放式手术方法，并总结了一种“逐步方法”来管理血管浸润。
