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Thomas J. Howard, MD

Arch Surg. 2007;142(2):180.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

This study is a careful analysis of a superb clinical experience combining PV resection with pancreaticoduodenectomy in patients with pancreatic adenocarcinoma who underwent operation with curative intent. I make this distinction, rather than using curative resection, because resection of pancreatic cancer, even under ideal circumstances (small tumor, no involved lymph nodes, negative margins, and minimal blood loss), is a palliative exercise. Effective, durable, hope-restoring, often long-term, but palliative nonetheless. We as surgeons want desperately to believe that our knowledge, technical skills, temerity, intuition, and experience can somehow be leveraged against overwhelming odds to achieve the purity of a surgical cure. The corollary, of course, is that anything less is viewed as a therapeutic failure—a concept that I am unwilling to accept. Rather, I choose to view these data as further confirmation of the surgeon's central role in the effective treatment of patients with pancreatic . . . [Full Text of this Article]

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