When there is exponential growth, division and spread of the cells in the tissues of the pancreas, the condition is termed as pancreatic cancer. Adenocarcinoma is the commonest type. These are aggressive tumors with poor outcome. Though it is unclear as to how certain people get pancreatic cancer, factors that contribute to it are smoking, obesity, genetic factors, and chronic pancreatitis.
Treatment decisions will be taken in a multidisciplinary meet (MDT). Doctors will suggest a treatment course based on the stage of cancer, location and the physical condition of the patient. Endoscopic ultrasonography (EUS) guided biopsy may be used to prove the diagnosis histologically. However, a positive biopsy is not mandatory before surgery. Surgery is indicated only if the disease is localized without any distant spread (like liver metastasis).
This surgery is indicated if the tumor located at the head or uncinate process of pancreas. This can be done by open as well as laparoscopic (keyhole) approaches. This is one of the major surgeries performed in the abdomen with its associated complications. If the patient is having severe infection in the bile duct (cholangitis), endoscopic stenting bile duct should be done pre-operatively. Patient may require additional therapy like chemotherapy depending on the final biopsy reports.
This surgery is done when the tumor is located in body or tail of the pancreas, often along with spleen to get adequate lymph nodal clearance. This can be done by open as well as laparoscopic (keyhole) approaches.
Surgical removal of the whole pancreas is called total pancreatectomy and is rarely performed. Patients develop diabetes after surgery as there is no insulin secreted in the body.
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