Perioperative Therapy for Resectable Pancreatic Cancer

Inclusion Criteria: * Patients must have histologically or cytologically confirmed diagnosis of localized, resectable or borderline resectable, pancreatic adenocarcinoma T1-T3, N0-N1, M0; stage is determined by helical multi-phase computed tomography (CT) and/or endoscopic ultrasound according to published guidelines; resectability is determined by the treating surgeon and published guidelines (National Comprehensive Cancer Network) * Resectable Disease- Head/Body/Tail of pancreas: * No distant metastases * Clear fat plane around celiac and superior mesenteric arteries (SMA) * Patent superior mesenteric vein (SMV) and portal vein (PV) * Borderline Resectable Disease -Head/Body of pancreas: * Tumor abutment on SMA * SMV/portal vein impingement or occlusion if involving only a short segment, with open vein both proximally and distally (if proximal vein is occluded up to the portal vein branches then disease is unresectable) * Colon or mesocolon invasion * Gastroduodenal artery (GDA) encasement up to origin at hepatic artery * Tail of pancreas: * Adrenal, colon or mesocolon, or kidney invasion * Preoperative evidence of biopsy-positive peripancreatic lymph node * No prior therapy for pancreatic cancer * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 (Karnofsky \>= 60%) * Leucocytes \>= 3,000/uL * Absolute Neutrophil Count \>= 1,500/uL * Platelets \>= 100,000/uL * Total Bilirubin: * If within normal limits (WNL) to =\< 2.0, the subject is eligible * If \> 2.0 - \< 6.0, subject is eligible IF they have a biliary stent and total bilirubin is decreasing * If \>= 6.0, subject is not eligible * Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT)(serum glutamate pyruvic transaminase \[SGPT\]) =\< 2.5 X institutional upper limit of normal or =\< 1.5 X upper limit of normal (ULN) if alkaline phosphatase (Alk Phos) \> 2.5 X ULN or if the subject has a biliary stent and the liver function tests (LFTs) are decreasing the subject is eligible * Creatinine clearance \>= 30% * Negative pregnancy test for women of childbearing potential; women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately * Ability to swallow and retain oral medication * Ability to understand and willingness to sign a written informed consent document Exclusion Criteria: * Patients may not be receiving any other investigational agents * Histology other than adenocarcinoma * Patients with permanently unresectable pancreatic adenocarcinoma as determined by the treating physician and published guidelines (National Comprehensive Cancer Network) * Unresectable disease * Head of pancreas: * Distant metastases (includes celiac and/or para-aortic) * SMA, celiac encasement * SMV/portal occlusion * Aortic, inferior vena cava (IVC) invasion or encasement * Invasion of SMV below transverse mesocolon * Body of pancreas: * Distant metastases (includes celiac and/or para-aortic); at the discretion of the treating surgeon, body and tail lesions that have positive celiac and/or para-aortic nodes in close vicinity to the primary may be borderline rather than unresectable * SMA, celiac, hepatic encasement * SMV/portal extended occlusion * Aortic invasion * Tail of pancreas: * Distant metastases (includes celiac and/or para-aortic) * SMA, celiac encasement * Rib, vertebral invasion * History of allergic reactions attributed to compounds of similar chemical or biologic composition to gemcitabine, docetaxel, capecitabine, oxaliplatin or other agents used in the study * Patients who have received prior chemotherapy or radiotherapy for the diagnosis of pancreatic cancer * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements * Inability to comply with study and/or follow-up procedures * Pregnancy or lactation * Human immunodeficiency virus (HIV)-positive patients receiving combination anti-retroviral therapy