Table of Contents

Section 1 defining the disease burden.- Pancreatic cancer in the population.- Pancreatic cancer biology.- Pancreatic cancer precursors (pancreas cysts).- Genetic syndromes and screening.- PDAC pathways.- Centralization of surgery and volume-outcome issues.- Education & training in pancreatic surgery.- research and progress in pancreatic surgery .- Section 2 Anatomy and physiology  .- Anatomy and embryology.- Anatomical variants.- Vascular supply - Important arterial and venous variants.- Lymphatic drainage and variants.-  Section 3 Symptoms and presentation (with pathophysiology) .- Intro: PDAC as a difficult disease to diagnose.- Jaundice .- cachexia and sarcopenia.- pain.- diabetes (new onset diabetes) Section 4 Imaging and preoperative staging .- Intro: goals of imaging /staging.- CT – protocol, pearls and pitfalls; resectable/borderline; locally advanced.- imaging after neoadjuvant therapy.- MRI – protocol, added value, cancer, cysts, accuracyetc.-  Standard for reporting imaging results.- EUS – cancer, cysts, FNAC, biopsy, sens/spec, accuracy, markers.- ERCP - indications, stenting.- MDT - multidisciplinary team meeting; tumor board.- when a diagnosis can not be confirmed.- Section 5 Pathology and laboratory - reporting and research .- Intro: personalized medicine and precision medicine.- gross pathology - important aspects and standards.- histopathology - important aspects and standard template.- tissue sampling for research - fresh frozen.- sampling from formalin fixed tissue- aspects.- tumor markers (and biomarker research).- blood samples for research - liquid biopsy, proteomics etc.- Genomics, NGS, molecular classification.- Section  6 Chemotherapy and radiation therapy.- history of chemoradiotherapy in PDAC.- Available drugs - mechanisms, effect and side-effects.- role and mechanisms of radiotherapy.- Adjuvant chemotherapy – best evidence.- Neoadjuvant treatment in upfront resectable – principles and ongoing trials.- NAT in borderline or locally advanced - indiuction chemo.- Use of organoid modles to monitor/choose chemotherapy.- something here on novel therapies: immunotherapy etc? Section 7 Perioperative management .- Anesthesia and peri-op  management.- Enhanced recovery – principles and standards.- Nutritional support and therapy in pancreatic surgery.- use of drains.- use of high-dependency unit/ICU/ward.-  Section  8 Surgery .- Intro: Surgery as a curative apporach to PDAC.- Surgery for pancreatic head cancers.- Surgery for body and tail cancers.- central resections and enucleations.- Artery-first approach.- Minimal invasive pancreatic surgery.- Venous resection .- Arterial resection.- Reconstruction techniques, variations.- DP-CAR.- Extended resection criteria – multiorgan, M1 disease etc .- total pancreatectomy.- Lymphadenecomty.- Should we resect PDAC with solitary metastatis (liver, lung).- Research gaps.

About the Author

Prof. Kjetil Soreide, MD, PhD, FRCS (Edin) is a general and GI surgeon specializing in HPB surgery. He has authored over 250 papers, of which the majority with a focus on GI oncology subjects. He has been the editor of the Br J Surgery since 2010, one of the world most premier surgical journals. He is a member of several surgical societies (European Surgical Association; European Society for Surgical Oncology; Society for Surgical Oncology; International Surgical Society, Society for Surgery of the Alimentary tract; the European and international HPB societies EAHPBA, IHPBA and more).

Assocciate Prof. Stefan Stättner MD, Priv. Doz Innsbruck, Austria; Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria. Stättner is a consultant HPB surgeon work in in Innsbruck. He did part of his HPB training in Liverpool under prof Graham Poston. He has published more than 40 papers on HPB topics and givenm numerous lectures around the world on the same. He is chairing several symposia on surgical oncology topics and is currently on the education and training comittees of both the EAHPBA and ESSO (the European societies for HPB surgery and Surgical Oncology).