Resection for pancreatic cancer with arterial involvement: A paradigm shift away from unresectable to “how to do it”

During the past 30 years, pancreatic surgery has evolved considerably. Honestly, I would not have anticipated many of these changes, but luckily enough, they have occurred and have improved the management and the prognosis of patients with pancreatic cancer. Some of these changes have been truly groundbreaking, such as the advent of minimally invasive distal and now even proximal pancreatectomies, the availability of effective medical therapies, and the improved definition of prognostic factors. In keeping with some of these changes, some centers have begun to extend their indications for pancreatic resections to arterial involvement. The value of these extended procedures, however, remains controversial.