Pancreatic carcinoma

Question 1

Symptoms

Answer 1

• Painless jaundice
• Abdominal pain
• Haematesis
• Weight loss/ anorexia

Question 2

Investigation

Answer 2

Abdominal US
CT
MRI

When with jaundice and Mass: ERCP
When mass but no jaundice: no ERCP

Then Biopsy with percutaneous needle
CT/EUS/Laparoscopy to stage

Question 3

Treatment/outcome

Answer 3

surgery when less than 3cm

Question 4

risk factors

Answer 4

westerners 
60-80 
Smoking 
Chronic pancreatitis 
FAP 
Hereditary pancreatitis

Question 5

Different types

Answer 5

Duct cell mucinous adenocarcinoma (75%)
Carcinosarcoma
Cystadenocarcimona
Acinar cell

Question 6

Signs of unresectable pancreatic carcinoma

Answer 6

• Hepatomegaly
• Jaundice
• Abdominal mass
• Ascites
• Splenomegaly
• Suprclavicular lymphadenopathy

Question 7

Surgeries available

Answer 7

• Whipples- pancreatic duodenopathy
• PPPD
• Stent or cholechoduodenostomy for jaundice

Question 8

What is PPPD

Answer 8

Pylorus preserving pancreatic duodenectomy

Question 9

Whipples disease?

Answer 9

Remove the pylorus and duodenum.

Anastamose stomach, bile duct and pancreas with SI

Question 10

PPPD

Answer 10

Remove duodenum and diseased part of pancreas.

Then anastomose the stomach, remaining pancreas and bile duct with the SI

Question 11

Cholechoduodenostomy

Answer 11

Anastomose the bile duct and the duodenum

Question 12

When is surgery performed?

Answer 12

When under 3CM

Less than 10% of patients have a resectable tumour