It is in the vast majority of cases of pancreatic cancer.
It occurs mostly after 40 years and especially in humans.
It can affect the pancreatic head in 80% of cases, or the body and tail of the pancreas.
Causes and Risk Factors
The cause is unknown.
It is more common in diabetics and in cases of chronic pancreatitis.
Some contributing factors are involved:
- A diet rich in fat and animal protein ...
The signs of the disease
Two kinds of disorder can be cancer of the pancreas: evidence of compression and signs of renal secretion.
Indeed, the pancreatic tumor is compressing the adjacent organs: bile duct, stomach, duodenum, nerve plexus, vessels ...
The secretion of pancreatic insufficiency causes diarrhea fat (steatorrhea). A breach associated endocrine pancreas causes diabetes.
Three symptoms dominate:
- Jaundice (jaundice retention), especially in cancer of the pancreas. The gall bladder is distended and palpable.
- Severe pain radiating to the back and under the ribs on the left, sometimes subsided when the patient bends forward (anteflexion) or when taking aspirin.
- A weight loss.
- In cancer of the body and tail of the pancreas, the liver is often very large. There may have esophageal varices, an enlarged spleen ...
Reviews and analyzes
The laboratory tests include: blood glucose and glucose tolerance by oral, amylase and urinary amylase, liver function, determination of steatorrhea, duodenal intubation.
The carcinoembryonic antigen is sometimes increased.
The antigens CA 19.9 and CA 50 are useful in monitoring, but they are not specific.
Signs of tumor compression may be seen by X-ray of bile ducts but the tumor can be detected by ultrasound, CT, MRCP or endoscopic retrograde cannulation of the ampulla of Vater.
Laparoscopy is sometimes necessary for diagnosis.
Depending on the location of the tumor, the surgeon removes:
- The tail of the pancreas with the spleen in cases of cancer of the tail;
- Entire pancreas (total pancreatectomy);
- A duodeno-cephalic pancreatectomy (DPC) in cancer of the head with anastomosis to jejunum to the stomach, bile duct and pancreatic duct.
It uses any surgical procedures (biliary bypass and / or gastro-enterostomy), certain drugs: analgesics, Questran, pancreatic, chemotherapy, radiotherapy.
Endocrine tumors of the pancreas
They are rare. They may be isolated or integrated in a multiple endocrine neoplasia. Symptoms depend on the hormone:
- Insulin: Hypoglycaemia;
- Gastrin: Zollinger-Ellison syndrome with diarrhea and stomach ulcers;
- Vasoactive intestinal polypeptide (VIP) syndrome, Verner-Morrison or pancreatic cholera (severe diarrhea)
- Glucagon: diabetes, ...
- Somatostatin (diabetes, steatorrhea).
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