Changes in Pancreatic Cancer Management and Surgical Treatment During the COVID-19 Pandemic.

: This study evaluated the impact of the COVID-19 pandemic on the surgical management of pancreatic ductal adenocarcinoma (PDAC) at a tertiary care hospital in Romania. The objective was to compare surgical volumes, tumor characteristics, and patient outcomes across three periods: pre-COVID, pandemic, and post-COVID. : A retrospective analysis of 622 PDAC patients who underwent surgery between February 2018 and February 2024 was conducted. The key variables analyzed included tumor size, type of surgery (curative vs. palliative), use of neoadjuvant therapy, postoperative complications, and ICU monitoring, among others. : During the pandemic, there was a 25% decrease in surgical interventions compared the number performed during the pre-pandemic period, with a significant increase in the number of patients undergoing surgical intervention following neoadjuvant treatment ( = 0.009) in the post-pandemic period. Post-pandemic, surgical volumes increased by 10%, and tumor sizes were smaller ( = 0.029). Postoperative outcomes, such as complications, remained stable across the periods, but intensive care unit monitoring increased significantly during the pandemic and post-pandemic periods. Hospital stay durations were significantly shorter during and after the pandemic ( < 0.05). : The COVID-19 pandemic led to delays in PDAC surgeries, but post-pandemic improvements in surgical volumes and early diagnosis are evident; however, further optimization of screening and treatment protocols is essential for improving patient outcomes.