Surgeons should note that preoperative treatment duration over six months significantly improves survival outcomes for patients undergoing conversion surgery for unresectable locally advanced pancreatic cancer.

• Patients receiving >6 months of preoperative treatment showed median overall survival of 50.4 months versus 29.7 months for those with ≤6 months (p<0.001).
• Identifying four key prognostic factors can stratify risk: long treatment duration, FOLFIRINOX regimen, normal tumor markers, and high nutritional index.

These findings could enhance patient selection and treatment planning in surgical settings.

• Patients with three or more favorable factors had a 5-year survival rate of 59.8%, compared to 26.3% for those with fewer.

Post-pancreatectomy acute pancreatitis is crucial in predicting complications after pancreatoduodenectomy.

• 24.3% of patients developed clinically relevant postoperative pancreatic fistula (cr-popf); 90-day mortality was 3.4% overall, spiking to 9.0% with cr-popf.
• Post-pancreatectomy acute pancreatitis (ppap) was linked to a 4.88 times higher risk of 90-day mortality, making it a key independent predictor.

Surgeons can enhance patient selection and outcomes by integrating ppap into risk models for better postoperative management.

• Major morbidity occurred in 35.8% of patients, with ppap present in 10.8%, often due to preoperative cholangitis and other anatomical factors.

This study reveals key clinicopathologic insights into perihilar intraductal papillary neoplasms (IPNBs) and their association with invasive carcinoma, informing surgical management.

• Of 27 cases, 21 had associated invasive carcinoma, highlighting the high incidence of malignancy in patients.
• Median tumor size was 2.8 cm, with invasive tumor size averaging 1.2 cm.

Understanding these characteristics can improve patient selection for surgical intervention and inform prognosis discussions.

• Genetic alterations linked to significant pathways could guide future targeted therapies.

Surgeons can now consider a new arterial reconstruction method for the left gastric artery (LGA) during distal pancreatectomy with celiac axis resection (DP-CAR).

• The common hepatic artery (CHA) can successfully supply the replaced left hepatic artery (RLHA), ensuring adequate blood flow.
• The procedure had an operative time of 215 minutes and only 35 ml of blood loss.

This innovative approach may improve outcomes in complex cases of pancreatic cancer.

• Indocyanine green fluorescence confirmed effective tissue perfusion during surgery.