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If the ERCP demonstrates normal pancreatic and common bile ducts, then the patient may be observed with close follow-up. B, Close-up view demonstrates adherence of the mass to the splenic vein.

If no metastases are detected by laparoscopy, the patient will undergo laparotomy. If the CT scan demonstrates metastases or definite involvement of the major vessels eg, portal vein or superior mesenteric artery by tumor, the patient’s diseases are classified as unresectable.

When the history and physical examination suggest the possibility of pancreatic cancer, the first diagnostic test the authors use a spiral computed tomography CT scan.

If a pancreatic mass is detected, then the patient is evaluated for operation. Findings on upper GI that suggest pancreatic cancer include extrinsic compression, displacement or encasement of the C-loop, mucosal invasion nodularity or spiculationor Frostberg’s reversed “3” sign. Advocates perform laparoscopy to determine if there are any peritoneal or liver metastases present that were not detected by the CT scan.


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Because many of these patients present with nonspecific gastrointestinal symptoms, however, an upper GI may be obtained. Some endoscopists may also obtain endoscopic needle aspiration or duct brushings cuidadls this point as well. If the duct anatomy is abnormal, then the patient is evaluated for operation.

If a patient is not an operative candidate, tissue confirmation of pancreatic cancer is the next step; this is done using CT- or cuifados fine-needle aspiration FNA.

Los botones se encuentran debajo. Patients are evaluated for operation on the basis of CT evidence for resectability and presence of metastases.

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If the biopsy is positive, then the patient can undergo endoscopic stenting or be reevaluated for a palliative bypass. Confirmation of pancreatic cancer with tissue involvement can initiate amigdzlectomia procedures, such as endoscopic stenting, chemotherapy, or reevaluation for an operative bypass.

Other factors that may influence whether or not a patient is an operative candidate are their ages and general overall medical condition. If the cause of the jaundice is amigfalectomia obstruction from a pancreatic tumor, the extra- and intrahepatic bile ducts are dilated. Livia de Rezende, Dr. B, Endoscopic retrograde cholangiopancreatography in the same patient showing a stricture between arrows in the pancreatic duct with significant distal pancreatic duct dilatation.

Intraoperative determination of resectability will then determine whether or not the patient is a candidate for a resection of the tumor or a palliative bypass procedure. B, Note the reversed “3” sign caused by amigdlaectomia nodular compression of the medial duodenal wall by the pancreatic cancer. Endoscopic FNA, biopsy, or brushings are also options. Ultrasound can be a useful diagnostic modality to evaluate a patient with jaundice of unknown etiology.


If the cause of the jaundice is intrahepatic, the ducts are of normal diameter. To make this website work, we log user data and share it with processors. It is therefore not recommended for screening if pancreatic cancer is strongly suspected.

Miguel Moreno Sanfiel, Dr.

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Barium studies of the gastrointestinal GI tract are not often used to evaluate patients with suspected pancreatic cancer. In patients determined to be candidates for operation, the use of laparoscopy as a first step is controversial.

A, Widened duodenal sweep and the suggestion of compression of part of the duodenal loop. Sobre el proyecto Amjgdalectomia Condiciones de uso. If metastases are present, laparotomy is avoided and the patient may undergo endoscopic stenting. Guayacos, Anemia, hipoprot Marcadores Tumorales: If the biopsy is negative, the patient can undergo laparoscopy and biopsy.

B, Atypical cells, as seen on this CT-guided needle aspiration sample, signify the presence of pancreatic carcinoma. B, Massive intrahepatic biliary dilatation secondary to obstruction of the common bile duct resulting from the pancreatic tumor.