Diseases of the pancreas and periampullary region form an important clinical group of malignant and benign diseases which still carry relatively high morbidity and mortality rates. Especially pancreatic ductal adenocarcinoma is associated with very poor outcome as the number of new cases per year is just slightly higher than the number of deaths from this disease. Therefore, treatment of these conditions should always be based on the highest evidence and technical level.

Surgery for diseases of the pancreas and periampullary region has evolved greatly during the last 15 years and several new surgical techniques have been described. According to some recent randomized trials and changes in medical treatment, several surgical dogmas have been refuted.

Better understanding of pathophysiology of diseases of the pancreas and periampullary region has led surgeons to change some traditional surgical approaches and techniques. Technological advances have improved the pancreatic surgery and in recent years were mainly performed in selected high volume centers. In order to make further progressions for better quality of life and elongation of survival expectancy of our patients, novel surgical techniques should become more widely available and accepted. We still urgently need studies with both enough statistical power and very carefully prepared methodology.

In the present special issue, we particularly take an interest in evidence-based novel surgical techniques and approaches and new understanding in the pathophysiology of diseases of the pancreas and periampullary region, especially in challenging clinical settings.

Potential topics include, but are not limited to:

• Local ablative strategies (RFA, Nanoknife)
• Artery first approach
• Arterial and venous resection
• Novel techniques of pancreatic anastomosis
• Laparoscopic and robotic approach
• Approach and outcome of duodenal, papilla, and distal cholangiocarcinoma
• Pancreatitis: step-up approach for infected necrotizing pancreatitis
• Timing and technique of percutaneous catheter drainage
• Minimally invasive necrosectomy (VARD, percutaneous necrosectomy)
• Endoscopic approach (drainage, necrosectomy)
• Management of chronic pancreatitis
• Management of groove pancreatitis