Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Distal pancreatic solid mass. Neuroendocrine tumor.Pancreatic adenocarcinoma.Solid neoplasm of indeterminate diagnosis.Distal pancreatic mucinous cystic neoplasms. Asymptomatic, ≥ 3 cm in size.Symptomatic, any size.Presence of a solid component.Dilated main pancreatic duct.Distal pancreatic symptomatic serous cystadenoma.Chronic calcific pancreatitis or small symptomatic pseudocyst limited to pancreatic tail (less common). +++ Absolute ++ Proximal mass requiring pancreatoduodenectomy.Known metastatic disease.Local invasion of structures that cannot be resected en bloc with the pancreas.Mass encasing mesenteric vessels, with loss of usual fat planes noted on preoperative imaging (CT, MRI, or endoscopic ultrasound [EUS]).Portal hypertension. +++ Relative ++ Cardiopulmonary comorbidities.Splenic vein thrombosis. ++ The patient should be supine.The skin is prepared from the level of the nipples to the pubis, extending along the flank.The abdomen is entered through a midline incision.Alternatively, a bilateral subcostal incision may be used. ++ Nothing by mouth with nasogastric tube decompression.Oral diet is resumed following removal of the nasogastric tube and resolution of postoperative ileus. ++ Pancreatic leak.Pancreatic fistula.Pancreatitis.Surgical site infection.Bleeding. Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth