slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
سرطان پانکراس PowerPoint Presentation
Download Presentation
سرطان پانکراس

Loading in 2 Seconds...

play fullscreen
1 / 35

سرطان پانکراس - PowerPoint PPT Presentation


  • 295 Views
  • Uploaded on

سرطان پانکراس. دکتر سیدمحمدرضا حکیمیان متخصص جراحی عمومی فلوشیپ جراحی سرطان. Types: . Neoplasms of the Endocrine Pancreas(25%) Neoplasms of the Exocrine Pancreas(75%) 75% arise within the head or uncinate process of the pancreas; l5 % are in the body, 10% are in the tail. Staging.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'سرطان پانکراس' - ivrit


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

سرطان پانکراس

دکتر سیدمحمدرضا حکیمیان

متخصص جراحی عمومی

فلوشیپ جراحی سرطان

types
Types:
  • Neoplasms of the Endocrine Pancreas(25%)
  • Neoplasms of the Exocrine Pancreas(75%)
  • 75% arise within the head or uncinate process of the pancreas;
  • l5 % are in the body,
  • 10% are in the tail
diagnosis stage
Diagnosis & stage:
  • 7% percent of pancreas cancer cases are diagnosed while the cancer is still confined to the primary site (localized stage);
  • 26% are diagnosed after the cancer has spread to regional lymph nodes or directly beyond the primary site
  • 52% are diagnosed after the cancer has already metastasized (distant stage); and
  • for the remaining l5% the staging information was unknown.
diagnosis
Diagnosis:
  • History & Ph Ex
  • CT scan(the single most versatile and costeffective tool for the diagnosis)
  • Sonography
  • MRI
  • Endosono
  • LFT
  • CA19-9
  • laparoscopy
multislice dynamic contrast enhanced ct with iv oral contrast pancreas protocol
Multislice, dynamic, contrast-enhanced CT with IV & oral contrast (pancreas protocol)
  • accuracy of CT scanning for predicting unresectable disease is about 90 to 95%
  • invasion of the hepatic or superior mesenteric artery,
  • enlarged lymph nodes outside the boundaries of resection,
  • ascites, and
  • distant metastases (e.g., liver).
  • Invasion of the superior mesenteric vein or portal vein is not in itself a contraindication to resection as long as the veins are patent.
  • C T scanning is less accurate in predicting resectablediseas
  • When all of the current staging modalities are used, their accuracy in predicting resectability is reported to be about 80%. 98% when laparoscopy with US is used.
paliative surgery
Paliative surgery:
  • Jaundice & pruritus ; stent with ERCP, PTC drinage (choledochojejunostomy is the preferred approach)
  • Duodenal obstruction (no bypass in the absence of signs or symptomes. Roux-en-Y limb with the gastrojejunostomylocated 50 cm downstream or a loop of jejunum with a jejunojejunostomy to divert the enteric stream away from the biliary-enteric anastomosis )
  • Pain (celiac plexus nerve block)
technique
Technique:
  • Complication rate: 31%
  • pancreatic leakage rate: about 10%
  • mortality rate for pancreaticoduodenectomy is <5% in "high volume" centers (where individual surgeons perform more than 15 cases per year)