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In patients with pancreatic cancer, surgery is the primary modality of treatment.
==Physical examination==
Extrapancreatic disease requires palliative therapy and curative resection is not performed in such patients.Patients with unresectable disease are treated with chemotherapy and/or radiation therapy as a part of adjuvant or neoadjuvant therapy.
==References==
Curative resection is not contraindicated in all patients with vascular invasion. Involvement of the portal or superior mesenteric vein can be resected and reconstructed with the help of splenic, saphenous or internal jugular veins. However, the involvement of arteries such as the hepatic, celiac or superior mesenteric are contraindications to resection.
{{reflist|2}}
Various methods of surgical resection may be employed and each of these has its own sets of risks and perioperative complications. The facts are discussed by the patient and surgical team before arriving at a well-informed decision.
The method of surgical resection depends on the following features:
*Locally invasive characteristics of the neoplasm
*Size
*Location
Methods of curative resection options include:
**Distal Pancreatectomy
*Total pancreatectomy
*Pancreaticoduodenectomy, where pylorus may or may not be spared on an individual basis


The National Comprehensive Cancer Network (NCCN) has recommended certain guidelines on resectability of pancreatic neoplasms:
{{WH}}
*Patient selection is based on:
{{WS}}
**Resection margins
 
**High probability of cure
==References==
**Patient's age
{{Reflist|2}}
**Comorbidities
 
 
European Society for Medical Oncology (ESMO) has certain guidelines on the treatment of metastatic pancreatic cancer:
===Pathophysiology prev===
*Chemotherapy not preferred
<div style="-webkit-user-select: none;">
*Gemcitabine is preferred over 5 FU
{| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
*Treatment is symptomatic with bypass surgery or stent placement for gastric outlet obstruction or obstructive jaundice
|-
| {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}}
In case of locally advanced disease which is unresectable, the following methods of treatment are preferred:
|-
Microwave ablation
|}
Photodynamic therapy
__NOTOC__
Irreversible electroporation
{{Cirrhosis}}
Photodynamic therapy
{{CMG}} {{AE}}
High-intensity focused ultrasound (HIFU)
 
Iodine-125–cryosurgery
 
Iodine-125
===Pathophysiology prev===
Stereotactic body radiation therapy (SBRT)
<div style="-webkit-user-select: none;">
Radiofrequency ablation (RFA)
{| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
|-
| {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}}
|-
|}
__NOTOC__
{{Cirrhosis}}
{{CMG}} {{AE}}
 
== History and Symptoms ==
 
* History should include:
** Appearance of bowel movements
** Travel history
** Associated symptoms
** Immune status
** Woodland exposure
==References==
{{reflist|2}}
 
{{WH}}
{{WS}}
 
==Other Imaging Findings==
* [[Endoscopy]]
* [[Barium enema]]
* [[Colonoscopy]]
* [[Sigmoidoscopy]]
 
==Other diagnostic studies==
== Other Diagnostic Studies ==
 
* Breath hydrogen test
 
* [[HIV test]]ing for those patients suspected of having HIV
 
==
 
==Overview==
 
==References==
{{reflist|2}}
 
{{WH}}
{{WS}}
 
===Pathophysiology prev===
<div style="-webkit-user-select: none;">
{| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
|-
| {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}}
|-
|}
__NOTOC__
{{Cirrhosis}}
{{CMG}} {{AE}}
 
==Video codes==
 
===Normal video===
{{#ev:youtube|x6e9Pk6inYI}}
{{#ev:youtube|4uSSvD1BAHg}}
{{#ev:youtube|PQXb5D-5UZw}}
{{#ev:youtube|UVJYQlUm2A8}}
 
===Video in table===
<div style="width:350px">{{#ev:youtube|5ucSlgqGAno}}</div>
 
===Floating video===
 
{| class="infobox mw-collapsible" id="floatvideo" style="position: fixed; top: 65%; width:361px; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
| Title
|-
|-
| {{#ev:youtube|https://https://www.youtube.com/watch?v=ypYI_lmLD7g|350}}
|-
|}
 
===Redirect===
#REDIRECT[[Esophageal web]]
 
===synonym website===
https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008
 
===Image===
[[Image: Normal versus Abnormal Barium study of esophagus.jpg|thumb|left|200px|Normal versus Abnormal Barium study of esophagus with varices]]
 
 
===Image to the right===
{| style="float: right; width: 350px;"
| [[Image:Coxiella burnetii.JPG|right|400px|C. burnetii, the Q fever causing agent]]
|}
 
===Image and text to the right===
 
<figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[File:Global distribution of leptospirosis.jpg|577x577px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline> Recent out break of leptospirosis is reported in Bronx, New York and found 3 cases in the months January and February, 2017.
 
===Gallery===
 
<gallery widths="250px">
 
Pancreatic insulinoma histology 2.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref>
 
Pancreatic insulinoma histopathology 3.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref>
 
Pancreatic insulinoma histology 4.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref>
 
</gallery>
==References==
{{Reflist|2}}
{{WS}}
{{WH}}
 
 
REFERENCES
<references />
 
[[Category:Gastroenterology]]
[[Category:Needs overview]]
[[Category:Hepatology]]
[[Category:Disease]]

Latest revision as of 00:04, 30 July 2020

Physical examination

References

Template:WH Template:WS

References


Pathophysiology prev

https://https://www.youtube.com/watch?v=5szNmKtyBW4%7C350}}

Cirrhosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cirrhosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Tertiary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case studies

Case #1

Sandbox:Cherry On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sandbox:Cherry

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sandbox:Cherry

CDC on Sandbox:Cherry

Sandbox:Cherry in the news

Blogs on Sandbox:Cherry

Directions to Hospitals Treating Cirrhosis

Risk calculators and risk factors for Sandbox:Cherry

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:


Pathophysiology prev

https://https://www.youtube.com/watch?v=5szNmKtyBW4%7C350}}

Cirrhosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cirrhosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Tertiary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case studies

Case #1

Sandbox:Cherry On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sandbox:Cherry

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sandbox:Cherry

CDC on Sandbox:Cherry

Sandbox:Cherry in the news

Blogs on Sandbox:Cherry

Directions to Hospitals Treating Cirrhosis

Risk calculators and risk factors for Sandbox:Cherry

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief:

History and Symptoms

  • History should include:
    • Appearance of bowel movements
    • Travel history
    • Associated symptoms
    • Immune status
    • Woodland exposure

References

Template:WH Template:WS

Other Imaging Findings

Other diagnostic studies

Other Diagnostic Studies

  • Breath hydrogen test

==

Overview

References

Template:WH Template:WS

Pathophysiology prev

https://https://www.youtube.com/watch?v=5szNmKtyBW4%7C350}}

Cirrhosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cirrhosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Tertiary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case studies

Case #1

Sandbox:Cherry On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sandbox:Cherry

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sandbox:Cherry

CDC on Sandbox:Cherry

Sandbox:Cherry in the news

Blogs on Sandbox:Cherry

Directions to Hospitals Treating Cirrhosis

Risk calculators and risk factors for Sandbox:Cherry

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Associate Editor(s)-in-Chief:

Video codes

Normal video

{{#ev:youtube|x6e9Pk6inYI}} {{#ev:youtube|4uSSvD1BAHg}} {{#ev:youtube|PQXb5D-5UZw}} {{#ev:youtube|UVJYQlUm2A8}}

Video in table

{{#ev:youtube|5ucSlgqGAno}}

Floating video

Title
https://https://www.youtube.com/watch?v=ypYI_lmLD7g%7C350}}

Redirect

  1. REDIRECTEsophageal web

synonym website

https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008

Image

Normal versus Abnormal Barium study of esophagus with varices


Image to the right

C. burnetii, the Q fever causing agent
C. burnetii, the Q fever causing agent

Image and text to the right

<figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline> Recent out break of leptospirosis is reported in Bronx, New York and found 3 cases in the months January and February, 2017.

Gallery

References

  1. 1.0 1.1 1.2 Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas

Template:WS Template:WH


REFERENCES