Pancreatic cancer afflicts nearly 27,000 people in the United States each year and is responsible for the death of most of these patients. It is the fourth leading cause of death by cancer in the United States.<sup>20 Doty J.E., Meyer J.H. Vagotomy and antrectomy impairs absorption of fat from solid, but not liquid dietary sources [abstract] Gastroenterology 1987 ;  97 (5 pt 2) : 1374

Cliccare qui per andare alla sezione Riferimenti</sup> The past century has seen essentially all of the growth in knowledge regarding the physiology of the pancreas and the ability to operate on the gland.

Cancer of the biliary tree is considerably less common than is pancreatic cancer but remains exceptionally lethal. Nearly 4000 deaths occur each year in the United States as a result of biliary tract cancers.<sup>67 Vital Statistics for the United States Vol II (Mortality), Part A for the years 1968–1989  Washington, DC: US Government Printing Office (1990). 

Cliccare qui per andare alla sezione Riferimenti</sup> More than half of these deaths are from cancer of the gallbladder. In some patients, gallbladder cancer is present in epidemic proportions. Gallbladder cancer is the leading cause of death by cancer in women in Chile. Biliary tract cancers include gallbladder cancer, cholangiocarcinomas, and unusual biliary tumors. These are discussed separately later.

Operative extirpation of these tumors is the mainstay of therapy and provides the only hope for long-term survival. Over the past 100 years, numerous advances have been made that have allowed physicians to develop a multidisciplinary approach to better detect, evaluate, and remove these tumors. This article reviews the evolution and development of the advances and techniques on which physicians base therapy for patients with pancreaticobiliary neoplasms.