2011 Surg 7
Card Set Information
2011 Surg 7
What are the patient and tumour factors to consider in the management of pancreatic cancer?
: age, functional status, co-morbidities, wishes
: stage (CT, MRI, endoscopy, laparotomy), resectability (mets, vaculature invasion), size, resection margins
What is the criteria for resectability in pancreatic cancer?
NO extra-pancreatic mets
NO occlusion or encasement of portal-mesenteric vasculature (SMA/SMV, aorta, portal v., celiac plexus)
What is the surgery for the removal of pancreatic cancer?
+/- pre-op ERCP biliary decompression
Standard pancreaticoduodenectomy (Whipples procedure)
: removes pancreatic head, duodenum, CBD, gallblader... etc.
May be variations of the procedure
How is adjuvant chemoradiotherapy used in pancreatic cancer?
Used for locally advanced pancreatic cancer that's not distally metastatic!
Describe the palliation issues for patients with met. pancreatic cancer (8 issues).
: opioids, celiac plexus block, radiotherapy
N & V
: biliary decompression (usually endoscopic instead of surgery bypass)
Gastric outlet obstruction
: open gastro-jejunostomy
: lipase & protease replacement
: psych r/v
: prolonged survival and improved QoL in 30% of pts