Pancreatic cancer requires specialist surgical expertise. Dr. Srinivas performs Whipple's procedure and complex pancreatectomies — including robotic surgery — with one of India's highest-volume HPB practices.
Pancreatic ductal adenocarcinoma (PDAC) is one of the most challenging cancers — often presenting late, with symptoms appearing only after significant local spread. Surgical resection remains the only potentially curative treatment.
However, only 15–20% of patients are initially found to be resectable. Expert evaluation can identify borderline resectable patients who can achieve resectability after neoadjuvant therapy.
No contact with major vessels. Surgery first. 5-year survival 15–25% with R0 resection.
Limited vessel contact. Neoadjuvant chemotherapy (FOLFIRINOX or Gem-nab-paclitaxel) first, then reassess for surgery. Dr. Srinivas coordinates with oncology for this pathway.
Significant vascular encasement. Downstaging with systemic therapy ± chemoradiation. Surgery considered if sufficient response.
Systemic therapy palliative intent. ERCP biliary stenting for jaundice relief. Pain management and nutritional support.
The most complex GI operation — removal of the pancreatic head, duodenum, common bile duct, and gallbladder, followed by reconstruction with three anastomoses (pancreatico-jejunostomy, hepatico-jejunostomy, gastro-jejunostomy).
For cancer of the pancreatic head (most common location).
Removal of the pancreatic body and tail with or without spleen. For tumours of the pancreatic body/tail.
Removal of the entire pancreas when tumour extent requires. Requires lifelong insulin and pancreatic enzyme replacement.
Biliary bypass (hepaticojejunostomy) and gastrojejunostomy for unresectable cases to relieve jaundice and gastric outlet obstruction.
