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Abdo Surgery > Pancreatic Carcinoma > Flashcards

Pancreatic Carcinoma Flashcards

1
Q

When is the peak incidence of pancreatic carcinoma

A

60-80 years

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2
Q

What are the predisposing factors for pancreatic carcinoma

A

Age - incidence increases after 50 years

Smoking

Diabetes

Chronic pancreatitis

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3
Q

What is the most common type of pancreatic carcinoma

A

Ductal carcinoma

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4
Q

Where do most pancreatic tumours occur

A

Head - 75%

Body - 15-20%

Tail - 5-10%

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5
Q

Where do pancreatic tumours invade

A

Spread locally:

  • Duodenum
  • Local lymph nodes
  • Portal vein
  • Nerve sheaths
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6
Q

Where do pancreatic tumours metastasise to

A

Liver

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7
Q

How do tumours of the head of the pancreas present

A

Obstructive jaundice (painless)

Nausea

Weight loss

Weakness

Palpable mass may be felt in the RUQ

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8
Q

What does painless jaundice usually suggest

A

Usually associated with malignancies

  • Carcinoma of ampulla of Vater
  • Extrahepatic cholangiocarcinoma
  • Ductal carcinoma of the pancreatic head
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9
Q

How do tumours of the pancreatic body and tail present

A

Only 20% with jaundice

Pain

Diabetes

Hepatomegaly

*Late presentation

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10
Q

What is Trousseau’s sign

A

Migratory superficial thrombophlebitis - recurrent thrombophlebitis appearing in different locations

Associated with pancreatic cancer

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11
Q

How would you investigate pancreatic carcinoma

A

US

Contrast enhanced CT

Endoscopic US and fine needle aspirate - highly sensitive and specific

ERCP and biopsy

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12
Q

What would you expect to find on US of a patient with pancreatic carcinoma

A

‘Double duct’ sign - both the common bile duct and the pancreatic duct are dilated

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13
Q

Why would you do a contrast enhanced CT when investigating pancreatic carcinoma

A

Give info about the spread and resectability

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14
Q

What is Whipple’s resection

A

The preferred technique for periampullary cancers

Removal of:

  • Head of pancreas
  • Gallbladder
  • Part of duodenum
  • Pylorus
  • Local lymph nodes
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15
Q

What are periampullary cancers

A

This term encompasses cancers of:

  • Head of pancreas
  • Duodenal cancers
  • Ampullary cancers
  • Lower bile duct cancers
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16
Q

What are some benign pancreatic tumours

A

Adenoma

Cystadenoma

Islet cell tumours

Zollinger-Ellison tumour

Insulinoma

Glucagonoma

VIPoma

Abdo Surgery (14 decks)

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