For surgeons, pancreatic cancer is the most challenging of the gastrointestinal malignancies. The tumor has spread in 80% of cases even before the diagnosis is made, so that surgical resection is an option in only about 20%. The operation (Whipple procedure) is the most complex of general surgical procedures, and cures less than 20% of those who undergo it. Nevertheless, some patients are cured by surgery (and additional medical therapy), and all patients who have ever been cured have had the tumor surgically removed. Thus, surgical resection will remain a central feature in the management of this disease for the foreseeable future.
