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Pancreatic Cancer Surgery Demystified: Criteria for borderline resectability and operability

In this detailed and insightful video on pancreatic cancer surgery, Dr. Gunjan Desai, a pancreatic surgeon based in Lilavati Hospital, Mumbai, delves into the nuanced and critical aspects of managing pancreatic cancer, focusing on resectability and operability. With his extensive expertise and dedication to advancing pancreatic cancer treatment, Dr. Desai begins by explaining the fundamental differences between resectability and operability, two essential terms in cancer management that are often misunderstood. Resectability refers to the feasibility of surgically removing the tumor based on its anatomical location and involvement of surrounding structures. At the same time, operability emphasizes the patient's overall fitness and medical condition to undergo a major surgery safely.

Dr. Desai then provides a step-by-step overview of assessing pancreatic cancer resectability, using advanced imaging techniques and a multidisciplinary approach. He highlights the importance of evaluating critical structures like the major blood vessels, including the superior mesenteric artery, superior mesenteric vein, and celiac axis, which are often involved in advanced cases. This assessment plays a pivotal role in determining whether a patient can benefit from surgery or should instead receive alternative therapies, such as chemotherapy or radiation.

The video further explores the National Comprehensive Cancer Network (NCCN) criteria for pancreatic cancer resectability. Dr. Desai meticulously explains the classification of tumors into resectable, borderline resectable, and locally advanced categories, emphasizing the importance of accurate staging and the role of a multidisciplinary tumor board in planning treatment. He discusses how the NCCN guidelines aid surgeons and oncologists in making evidence-based decisions to optimize patient outcomes.

Lastly, Dr. Desai introduces the ABC operability criteria, which focus on assessing the patient's ability to withstand the physiological demands of surgery. He discusses how factors such as age, nutritional status, cardiac and pulmonary health, and pre-existing comorbidities are carefully evaluated to ensure that the surgery is not only technically feasible but also safe for the patient. By integrating both the NCCN and ABC criteria, Dr. Desai provides a comprehensive framework for managing pancreatic cancer, offering valuable insights for both medical professionals and patients.

This video serves as an essential resource for anyone seeking a deeper understanding of pancreatic cancer surgery, blending technical expertise with a compassionate approach to patient care. Join Dr. Gunjan Desai as he demystifies these critical concepts and shares his vast knowledge to enhance awareness and treatment outcomes for this challenging disease.




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