Pancreas Flashcards
Ranson’s criteria
4 clinical stages of pancreatic cancer
- Resectable
- Borderline resectable
- Locally advanced (unresectable)
- Metastatic
Resectable characteristics
- Less than 50% involvement of portal vein /SMV
- No involvement of hepatic artery or SMA
Borderline resectable characteristics
- > 180 involvement of portal vein/SMV with ability to reconstruct
- < 180 involvement of SMA or celiac and only up to short segment encasement of Hepatic artery (amenable to recontruction)
Advantages of neoadjuvant chemo in pancreatic cancer
median survivaal 34 vs 24 months
lower rate of LN mets
Higher rate of
First jejunal branch of SMV travels where in relation to SMA
Behind usually.
Pancreatic cysts
MCN (% of cysts, % malignant, location, gender, age)
30% of pancreatic cysts
20% malignant
distal pancreas
women
45-50 years old
differentiating factors between SCA, MCN, IPMN
Microcystic SCA - honeycomb
Macrocystic SCA compared to MCN - SCA has central calcifications vs MCN has peripheral calcifications
IPMN vs SCA or MCN - IPMN connects with duct, while others do not.
MRCP good study to differentiate in addition to EUS with fluid analysis
3 main genes for chronic pancreatitis
- PRSS1
- CFTR
- Spink1
beger vs berne
beger has 2 anastomosis - berne is like a frey without the longintudinal component.
Percent pain relief after pancreatic resection for chronic pancreatitis
85%
modified Atlanta classifcation for complicated acute pancreatitis
abnormal amount of fat excreted consistent with steathorrhea
7g daily on fecal fat study
Functional pancreatic NETs
Serum markers secreted by all pancreatic NETs including nonfunctional ones
chromogranin A, PP, neuron specific enolase
Grading of pancreatic neuroendocrine tumors based on mitotic count and Ki-67 index
Familial syndromes associated with PanNETs
similar to pheo
MEN
VHL
Neurofibromatosis
tuberous sclerosis