Utilizing an artery-first approach for distal pancreatectomy with celiac axis resection can effectively manage blood loss and maintain low mortality in pancreatic cancer surgery.

• In a study of 14 patients, R0 resection was achieved in all cases, with a 90-day mortality rate of 0%.
• The median operation time was 469 minutes, and median blood loss was 286.5 ml, although two patients experienced significant hemorrhage due to inflow control loss.

While this technique shows promise, surgeons must maintain careful control of arterial clamping to minimize complications.