RecruitingPhase 2Drug trialStimulation With Bethanechol in Combination With Gemcitabine and Nab-paclitaxel in Pancreatic AdenocarcinomaThe primary objective of this study is to assess the impact of bethanechol therapy on R0 resection rates. The safety objective will be assessment of the safety and tolerability of bethanechol in combination with gemcitabine and nab-paclitaxel. The exploratory objective will be to evaluate genomic biomarkers associated with parasympathetic stimulation in pancreatic cancer, and the ability to reduce tumor growth rate.