Abstract
Periampullary neoplasms encompass a broad range of pathologies that represent a diagnostic and therapeutic challenge for the surgeon. A multimodal diagnostic workup and multidisciplinary management team offer improved outcomes for patients with these difficult-to-treat diseases. Pancreaticoduodenectomy (PD) is the definitive surgical management and only potential curative option for most periampullary tumors. Open and minimally invasive approaches to PD are increasingly safe and effective, particularly at high-volume centers. Overall mortality after PD is low, although morbidity remains high. Delayed gastric emptying, postoperative pancreatic fistula, and postpancreatectomy hemorrhage are the most common complications after PD and require specialized management. While technical considerations are important, disease biology remains the primary driver of long-term patient outcomes.
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