Pancreatic
Cholangiocarcinoma Center
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“Maximize treatment effect through scientific and detailed diagnosis and early detection”
Introduction
The pancreas is an organ located on the left side of the duodenum, on the retroperitoneal wall and secreting digestive juices and insulin. Pancreatic cancer has no typical symptoms and is difficult to diagnose and early detection due to the location of the pancreas. It is also a terrifying disease that progresses so rapidly that more than 80% of diagnosed patients die within 1 year, and over 95% within 5 years. There have been many studies on diagnosis and treatment until now, but there are many cases where radical resection is impossible because it has already infiltrated into surrounding organs at the time of diagnosis. Even with surgical treatment, the median survival is only 18 to 20 months.
Symptom
Most patients with pancreatic cancer show late symptoms, and only about 20% of patients can resection the tumor at the time of diagnosis. However, in the case of a tumor that occurs in the head of the pancreas, jaundice appears relatively early and requires a visit to the hospital. However, when a tumor develops in the tail or body, there are often no symptoms, so it is often the case that metastasis to other organs has already occurred at the time of diagnosis. With the exception of jaundice, the initial symptoms usually develop slowly 2 months before diagnosis. Depending on where it occurs, jaundice, abdominal pain, and weight loss may be the most common symptoms, but there may be only abdominal pain and weight loss without jaundice. Most are asymptomatic and sometimes accompanied by symptoms such as weight loss, jaundice, pain, and anorexia.risk factor
Tobacco is the most well-known risk factor. In addition, chronic pancreatitis, diabetes, gastrectomy, and a family history of pancreatic cancer have been linked, and high-calorie foods are also associated with pancreatic cancer. No clear causal relationship has been established for coffee or alcohol.Diagnosis
- Abdominal ultrasound
In people with jaundice, it is the first test used to determine whether the cause is within the liver or outside the liver. However, the sensitivity and specificity of ultrasound in diagnosing pancreatic cancer is low, and satisfactory results cannot be obtained in about 25% of patients, especially due to obesity and intestinal air.- CT
As a useful diagnostic method for diagnosing and staging pancreatic cancer, it is possible to know not only the location of the lesion, but also the possibility of resection of the tumor and the anatomical structure of blood vessels. However, it can also be negative if the tumor is less than 2 cm in size.- MRI
Recently, there is a report that the tumor detection rate is superior to that of CT as a widely used test. It is mainly used to understand the morphological structure of the pancreatic duct and biliary tract, and to identify the vascular invasion of the tumor.- Endoscopic ultrasound
It is known to be the most useful test for detecting pancreatic cancer that is smaller than 2 cm. Therefore, it is used to detect tumors that are difficult to see in radiological examinations such as CT and MRI, and is used to safely confirm pancreatic cancer through biopsy if necessary.- Endoscopic retrograde cholangiopancreatography (ERCP)
It is used to diagnose some pancreatic cancers as well as to treat jaundice that occurs in the pancreas in cases of inoperable pancreatic cancer.Treatment
In principle, the treatment of pancreatic cancer is to remove the cancerous tissue with surgery if possible. However, in most cases, surgical treatment is not possible, so endoscopic retrograde cholangiopancreatography (ERCP) is used to treat jaundice medically.Examples of Endoscopic Biliary Drainage
If jaundice is severe because pancreatic cancer blocks the bile duct, endoscopic retrograde cholangiopancreatography (ERCP) is performed to observe the blockage and endoscopically pierces the blockage using a plastic or metal stent.
