Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer. How I do It

Sjors Klompmaker, Ugo Boggi, Thilo Hackert, Roberto Salvia, Matthew Weiss, Hiroki Yamaue, Herbert J. Zeh, Marc G. Besselink

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Approximately 30% of all pancreatic cancer patients have locally advanced (AJCC stage 3) disease. A sub-group of these patients—where the cancer only involves the celiac axis—may benefit from distal pancreatectomy with celiac axis resection (DP-CAR). Previous studies have shown that DP-CAR offers a survival benefit to a selected group of patients with otherwise unresectable pancreatic cancer, when performed by experienced pancreatic cancer treatment teams at high-volume centers. This article proposes a standardized approach to DP-CAR, including routine neoadjuvant (FOLFIRINOX) chemotherapy. This approach to selecting patients and performing DP-CAR has the potential to improve short-term outcomes and overall survival in selected patients, but it should be reserved for high-volume centers.

Original languageEnglish (US)
Pages (from-to)1804-1810
Number of pages7
JournalJournal of Gastrointestinal Surgery
Issue number10
StatePublished - Oct 1 2018


  • Appleby
  • Cancer
  • DP-CAR
  • High volume
  • Ischemia
  • Morbidity
  • Mortality
  • Pancreas
  • Pancreas surgery
  • Pancreatic cancer
  • Pancreatic fistula
  • Survival
  • Technique

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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