Development of pancreatoduodenectomy in North America

Purpose. Pancreatoduodenectomy has been developed over more than 100 years, with contributions being made by many countries to the various aspects of the technique. Methods. This review outlines the contributions of America toward the technical conduct of the procedure. Results. There have been seven phases of the development and refinement of pancreatoduodenectomy from 1935 until now: Phase 1, development and feasibility (1935-1950); Phase 2, radicality of the procedure (1960-1975); Phase 3, total pancreatectomy (1960-1975); Phase 4, pylorus preservation (1975-1985); Phase 5, surgical experience trials (1980-2000); Phase 6, adjuvant treatments (1990 to now); and Phase 7, minimally invasive techniques (1995 to now). Conclusions. In conjunction with Japan, Germany, Italy, France, and many other countries, North America has contributed substantially to the development of the current, state-of-the-art performance of pancreatoduodenectomy and its evaluation.