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| __NOTOC__
| | ==Physical examination== |
| {{Pancreatic cancer}} | | ==References== |
| {{CMG}}; {{AE}} {{Cherry}} | | {{reflist|2}} |
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| | {{WH}} |
| | {{WS}} |
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| | ==References== |
| | {{Reflist|2}} |
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| {| class="wikitable"
| | ===Pathophysiology prev=== |
| ! rowspan="2" |Disease
| | <div style="-webkit-user-select: none;"> |
| | rowspan="2" |Abdominal pain
| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
| ! colspan="2" |History and Symptoms
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| | rowspan="2" |Fever
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| ! rowspan="2" |Physical examination
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| ! rowspan="2" |Laboratory findings
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| ! rowspan="2" |Imaging findings
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| ! rowspan="2" |Comments
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| |- | | |- |
| !Steatorrhea
| | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
| !Weight loss
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| |- | | |- |
| |[[Chronic pancreatitis]] | | |} |
| |✔
| | __NOTOC__ |
| |✔
| | {{Cirrhosis}} |
| |✔
| | {{CMG}} {{AE}} |
| |<nowiki>-</nowiki>
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| | | | |
| |[[Diabetes mellitus|DM type II]], [[amylase]] and [[lipase]] levels may be slightly elevated
| | ===Pathophysiology prev=== |
| |CT scan shows calcifications of the pancreas
| | <div style="-webkit-user-select: none;"> |
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| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
| * It is differentiated from pancreatic cancer on the basis of histology.
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| * presents with malabsorption, malnutrition, and pancreatic endocrine insufficiency.
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| * past history of repeated admission for acute pancreatitis or alcohol abuse.
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| |Pancreatic cancer | | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
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| |Ampullary carcinoma | | |} |
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| | __NOTOC__ |
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| | {{Cirrhosis}} |
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| | {{CMG}} {{AE}} |
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| | == History and Symptoms == |
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| | * History should include: |
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| | ** Appearance of bowel movements |
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| | ** Travel history |
| |Autoimmune pancreatitis
| | ** Associated symptoms |
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| | ** Immune status |
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| | ** Woodland exposure |
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| | ==References== |
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| | {{reflist|2}} |
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| | {{WH}} |
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| | ==Other Imaging Findings== |
| |Lymphoma
| | * [[Endoscopy]] |
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| | * [[Barium enema]] |
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| | * [[Colonoscopy]] |
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| | * [[Sigmoidoscopy]] |
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| | ==Other diagnostic studies== |
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| | == Other Diagnostic Studies == |
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| | * Breath hydrogen test |
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| |Pancreatic endocrine tumors
| | * [[HIV test]]ing for those patients suspected of having HIV |
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| | == |
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| | ==Overview== |
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| | ==References== |
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| | {{reflist|2}} |
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| | {{WH}} |
| |Acute pancreatitis | | {{WS}} |
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| | ===Pathophysiology prev=== |
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| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
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| |Cholangitis
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| |Biliary obstruction
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| |Pseudocyst | |
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| |Pancreatic duct stricture/stone
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| |Cholecystitis
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| |Chronic gastritis
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| |Bile duct stones
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| |Intestinal perforation | | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
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| |Crohn disease
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| |Myocardial infarction
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| |Mesenteric artery ischemia
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| |Peptic ulcer disease
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| |[[Retroperitoneal hematoma]]
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| |✔
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| |[[Anemia]]
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| |[[MRI]] is the best radiologic tool to differentiate between retroperitoneal masses.
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| |[[Retroperitoneal abscess]]
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| |✔
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| |✔
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| |[[Leukocytosis]], positive inflammatory markers
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| |Retroperitoneal tumors (.e.g. [[liposarcoma]])
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| |✔
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| |✔
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| |✔
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| |positive [[tumor marker]]
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| |} | | |} |
| Obstructive jaundice may be painful due to calculous disease. Patients may be younger.
| | __NOTOC__ |
| | {{Cirrhosis}} |
| | {{CMG}} {{AE}} |
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| Stones can be demonstrated on abdominal ultrasound, both in the gallbladder and in the bile duct. However, stones may also be seen in patients with pancreatic cancer. ERCP will clarify the situation by ruling out stricture (seen in pancreatic cancer) and confirming bile duct stones, which can be cleared at the time of intervention.
| | ==Video codes== |
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| ==Treatment Options by Stage== | | ===Normal video=== |
| ===Stages I and II Pancreatic Cancer===
| | {{#ev:youtube|x6e9Pk6inYI}} |
| Treatment of stage I and stage II pancreatic cancer may include the following:
| | {{#ev:youtube|4uSSvD1BAHg}} |
| * Surgery alone.
| | {{#ev:youtube|PQXb5D-5UZw}} |
| * Surgery with chemotherapy and radiation therapy.
| | {{#ev:youtube|UVJYQlUm2A8}} |
|
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| ===Stage III Pancreatic Cancer=== | | ===Video in table=== |
| Treatment of stage III pancreatic cancer may include the following:
| | <div style="width:350px">{{#ev:youtube|5ucSlgqGAno}}</div> |
| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
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| * Chemotherapy with gemcitabine.
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| ===Stage IV Pancreatic Cancer=== | | ===Floating video=== |
| Treatment of stage IV pancreatic cancer may include the following:
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| * Chemotherapy with gemcitabine with or without erlotinib.
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| * Palliative treatments for pain, such as nerve blocks, and other supportive care.
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| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
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| ===Treatment Options for Recurrent Pancreatic Cancer=== | | {| class="infobox mw-collapsible" id="floatvideo" style="position: fixed; top: 65%; width:361px; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
| Treatment of recurrent pancreatic cancer may include the following:
| | | Title |
| * Chemotherapy.
| | |- |
| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
| | |- |
| * Palliative radiation therapy.
| | | {{#ev:youtube|https://https://www.youtube.com/watch?v=ypYI_lmLD7g|350}} |
| * Other palliative medical care to reduce symptoms, such as nerve blocks to relieve pain.
| | |- |
| | |} |
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| ===prevention=== | | ===Redirect=== |
| | #REDIRECT[[Esophageal web]] |
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| Primary
| | ===synonym website=== |
| Cessation of cigarette smoking: The risk of pancreatic cancer falls with cessation of cigarette smoking, which is one of the most important modifiable risk factors.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid23921790">{{cite journal |vauthors=Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C |title=Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980 |journal=Ann. Oncol. |volume=24 |issue=10 |pages=2657–71 |year=2013 |pmid=23921790 |doi=10.1093/annonc/mdt301 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
| | https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008 |
| Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16127228">{{cite journal |vauthors=Qiu D, Kurosawa M, Lin Y, Inaba Y, Matsuba T, Kikuchi S, Yagyu K, Motohashi Y, Tamakoshi A |title=Overview of the epidemiology of pancreatic cancer focusing on the JACC Study |journal=J Epidemiol |volume=15 Suppl 2 |issue= |pages=S157–67 |year=2005 |pmid=16127228 |doi= |url=}}</ref>
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| Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.<ref name="pmid25076322">{{cite journal |vauthors=Toki MI, Syrigos KN, Saif MW |title=Risk determination for pancreatic cancer |journal=JOP |volume=15 |issue=4 |pages=289–91 |year=2014 |pmid=25076322 |doi= |url=}}</ref>
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| The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.<ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
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| | ===Image=== |
| | [[Image: Normal versus Abnormal Barium study of esophagus.jpg|thumb|left|200px|Normal versus Abnormal Barium study of esophagus with varices]] |
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| Regular exercise:
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| Obesity is considered as a potential risk factor for pancreatic cancer.<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref>
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| Regular exercise decreases the risk of pancreatic cancer as compared to people living a sedentary lifestyle.<ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid25246281">{{cite journal |vauthors=Kollarova H, Azeem K, Tomaskova H, Horakova D, Prochazka V, Martinek A, Shonova O, Sevcikova J, Sevcikova V, Janout V |title=Is physical activity a protective factor against pancreatic cancer? |journal=Bratisl Lek Listy |volume=115 |issue=8 |pages=474–8 |year=2014 |pmid=25246281 |doi= |url=}}</ref>
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| The American Cancer Society (ACS) has issued guidelines for diet and physical activity at individual and community levels.
| | ===Image to the right=== |
| Diet:
| | {| style="float: right; width: 350px;" |
| A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:<ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
| | | [[Image:Coxiella burnetii.JPG|right|400px|C. burnetii, the Q fever causing agent]] |
| plenty of vegetables and fruits- blueberries, spinach, broccoli, tomatoes
| | |} |
| lean meat from fowl, fish and plant sources like nuts or whole grains
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| monounsaturated fats help control insulin levels in type 2 diabetics<ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
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| Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties
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| Poor diet: A poor diet includes the presence of the following:<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
| | ===Image and text to the right=== |
| Food preservatives and additives
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| Smoked meat
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| Heavy alcohol use
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| High cholesterol
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| Red meat
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| Low consumption of fruits and vegetables
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| Saturated fatty acids
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| Processed foods
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| high-fat, high-protein diet
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| Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, are capable of damaging cells and DNA, influencing cancerogenic processes
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| Aging: Aging is associated with the development of pancreatic cancer.<ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref>
| | <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. |
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| | ===Gallery=== |
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| Secondary
| | <gallery widths="250px"> |
| Diet: Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
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| Malabsorption in patients presents with anorexia, weight loss, and diarrhea.
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| Treatment: based on American Cancer Society(ACS) guidelines<ref name="pmid22237782">{{cite journal |vauthors=Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T |title=American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity |journal=CA Cancer J Clin |volume=62 |issue=1 |pages=30–67 |year=2012 |pmid=22237782 |doi=10.3322/caac.20140 |url=}}</ref>
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| Pancreatic enzyme replacement therapy
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| avoidance of high-protein/high-fat diets
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| Individualized dietary prescriptions from a registered dietitian
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| Supplementation with omega-3 fatty acids
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| === Palliative Therapy ===
| | 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> |
| * [[Pain]]:
| |
| ** There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients with advanced stage of [[pancreatic cancer]]:
| |
| *** [[Narcotic]] [[Analgesic|analgesics]]
| |
| *** [[Narcotic]] [[Analgesic|analgesics]]+ [[Tricyclic antidepressant|tricyclic antidepressants]]/ [[Antiemetic|antiemetics]]
| |
| *** [[Radiation therapy]]
| |
|
| |
|
| ==== Pain: ==== | | 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> |
| * There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients.
| |
|
| |
|
| * Surgical techniques used to treat [[pain]] in advanced [[pancreatic cancer]] cases include:
| | 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> |
| ** [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] or [[pancreatic duct]] [[obstruction]]
| |
| ** [[Neurolysis]] of the [[celiac ganglia]] by many approaches:
| |
| *** Intraoperative
| |
| *** Transgastric
| |
| *** Transthoracic
| |
| *** Transabdominal
| |
|
| |
|
| ==== Jaundice: ==== | | </gallery> |
| * [[Jaundice|Obstructive jaundice]] can present with features of [[cholangitis]]:
| | ==References== |
| ** [[Fever]] and [[Rigor|chills]]
| | {{Reflist|2}} |
| ** [[Nausea and vomiting|Nausea]], [[Nausea and vomiting|vomiting]]
| | {{WS}} |
| ** [[Acholic stools|Clay-colored stools]]
| | {{WH}} |
| ** Dark [[urine]]
| |
| ** Yellowish discoloration of skin
| |
| ** [[Itch|Pruritus]]
| |
| ** [[Abdominal pain|Right upper quadrant pain]]
| |
| ** [[Anorexia]]
| |
| * Preferred treatment in patients: [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] [[obstruction]].
| |
| * Techniques of [[Bile duct|biliary]] [[decompression]]:
| |
| ** ''Cholecystojejunostomy''
| |
| ** ''Choledochojejunostomy''
| |
|
| |
|
| *Types of [[Stent|stents]]:
| |
| **Metal- costly, longer lifespan
| |
| **Plastic- cheaper, need replacement every three months
| |
|
| |
|
| ==== Duodenal obstruction ====
| | REFERENCES |
| * Preferred treatment:
| |
| ** [[Endoscopy|Endoscopic]] [[Stent|stenting]] of [[Duodenum|duodenal]] [[obstruction]]
| |
| ** [[Gastrojejunostomy]]
| |
| <references /> | | <references /> |
| | |
| | [[Category:Gastroenterology]] |
| | [[Category:Needs overview]] |
| | [[Category:Hepatology]] |
| | [[Category:Disease]] |
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![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/2/2f/Pancreatic_insulinoma_histology_2.JPG)
Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/a/a3/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[1]![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/d/d5/Pancreatic_insulinoma_histology_4.JPG)
Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_4.JPG)