You're very welcome, and I hope it helps lead to a positive outcome.

One thing I meant to elaborate on a little more was the neoadjuvant treatment. There was a study (can't find it & don't remember name) showing patients who got chemo before surgery had better outcomes (don't remember the exact outcome criteria either) than those who got surgery first.

Part of it is based on the likelihood that even without evidence of spread, there is often an undetectable "micro-level" spread already to places that surgery would miss, and that surgery with a tough recovery period would delay the start of "adjuvant" chemo to address it, which lets it spread anyway. Their thought process is that surgery in that case just puts the patient through unnecessary agony on the way to the inevitable. With neoadjuvant chemo, they figure a) it gives drugs a chance to target malignant cells that have spread elsewhere; and b) if they do see a spread while the patient was on chemo, then they conclude it was not controllable before surgery and thus would not have been controllable with basic chemo after the surgery. Sort of a patient-screening process to see who really benefits from surgery.

Another level of screening occurs when they do the actual surgery. While the actual procedure may be done "open" or laparoscopically, they typically do a "diagnostic laparoscopy" at the beginning of the procedure. It just means they make the minimal laparoscopic openings, insert some cameras, and look around. If they see evidence of tumors elsewhere, in too many places or a couple bad places, they close up and abort the bigger surgery.

"TNT" (TOTAL NEOadjuvant Therapy) is the approach of doing all chemo before surgery, and none after, on the presumption that if you got a full dose and could tolerate it, that's the best they could do. It was part of the failure in my case (faster spread after recurrence), which is one reason I'm not a fan.

I've attached a paper, with a quote from page 2, "During the last twenty years, it has been well established that all surgical approaches to pancreatic cancer need to be supplemented by adjuvant therapy."

But there are two 10-minute sides of that debate worth watching here:
https://youtu.be/naQ-HlZbEoI (Dr. Jordan Berlin, Vanderbilt, for TNT)
https://youtu.be/nd1l5-GrdVQ (Dr. Matthew Katz, MD Anderson, for surgery first)