Pancreatic cancer surgical oncology లో most challenging cancers లో ఒకటి. AIIMS లో high-volume Whipple's training. Resectability careful గా assess చేసిన తరువాత మాత్రమే surgery. Pancreatic cancer is one of the most challenging in surgical oncology. High-volume Whipple's training at AIIMS. Surgery only after careful resectability assessment.
నేను pancreatic cancer patients కి ఒక honest thing చెప్తాను. Surgery possible అయిన cases లో (resectable cases) surgery ఒక్కటే currently long-term survival offer చేయగలదు. కానీ, diagnosis అయిన cases లో దాదాపు 15-20% మాత్రమే upfront resectable. మిగతా cases లో neoadjuvant chemotherapy తరువాత reassessment అవసరం.
Whipple's Procedure (pancreaticoduodenectomy) pancreatic head cancers కి standard. AIIMS లో నా training లో ఈ procedure high volume లో చేశాను. ISGPS (International Study Group on Pancreatic Surgery) guidelines follow చేస్తాను.
Surgeon volume matters enormously here. Published literature: low-volume centres లో Whipple's mortality 10-15%, high-volume specialised centres లో 2-3%. ఇది choice of surgeon కి important consideration.
I tell pancreatic cancer patients one honest thing. In cases where surgery is possible (resectable cases), surgery is currently the only treatment that can offer long-term survival. But only about 15-20% of diagnosed cases are upfront resectable. The rest need reassessment after neoadjuvant chemotherapy.
Whipple's Procedure (pancreaticoduodenectomy) is the standard for pancreatic head cancers. During my AIIMS training, I performed this procedure in high volumes. I follow ISGPS (International Study Group on Pancreatic Surgery) guidelines.
Surgeon volume matters enormously here. Published literature shows mortality at low-volume centres is 10-15% for Whipple's, compared to 2-3% at high-volume specialised centres. That is an important consideration in choosing a surgeon.
For pancreatic head and periampullary cancers. Removes pancreatic head, duodenum, gallbladder and part of bile duct. 6-8 hour surgery, 7-10 day stay.
For cancers in body or tail of pancreas. Often combined with splenectomy. Laparoscopic approach in suitable cases.
For cancers involving the entire pancreas. Results in insulin-dependent diabetes. Only when necessary.