Pancreatic surgery.

Recent advances have been made in both laparoscopic and endoscopic techniques for diagnosing and treating pancreatic neoplasms. These advances are reviewed. In addition to the traditional methods of pancreatic resection (eg, standard Whipple and pylorus-preserving Whipple), several other techniques have been described and are discussed (eg, median pancreatectomy and extended pancreatectomy). The morbidity and mortality rates of pancreatic operations have diminished, but significant complications still occur (eg, delayed gastric emptying, pancreatic fistula, and biliary strictures). These are discussed. In managing acute and chronic pancreatitis, less invasive and more conservative approaches are being advocated.