B55. Symptomatology and surgical management of pancreatic tumors.

Page created on October 4, 2021. Last updated on April 13, 2022 at 13:52

Introduction

For introduction, etiology, and pathology, see the corresponding pathology 2 topic. For clinical features, diagnosis, and evaluation, see internal med topic 70. For palliative surgery, see topic B47.

Treatment

Even with curative treatment, the survival rate of pancreatic cancer is poor. The 5-year survival after radical surgery + adjuvant oncological therapy is only 15 – 40%. The median survival is only 18 months.

There are two options for surgical treatment of pancreatic head tumours, conventional pancreaticoduodenctomy (Whipple procedure), and pylorus-preserving pancreaticoduodenectomy. See also topic B35. Both should be combined with regional lymphadenectomy.

For resectable tumours in the body or tail of the pancreas, an extended distal pancreatectomy is performed, usually with splenectomy.

Adjuvant chemotherapy is frequently used, usually with gemcitabine or 5-FU, combined with erlotinib.

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