3.3.1 Surgical Approaches to Pancreatic Cancer Flashcards Preview

GI and Nutrition > 3.3.1 Surgical Approaches to Pancreatic Cancer > Flashcards

Flashcards in 3.3.1 Surgical Approaches to Pancreatic Cancer Deck (36)
Loading flashcards...
1
Q

What is the most common # of pancreatodeudenectomy’s done in hospitals? What is the mortality rate?

A

1-5; 12-18%

2
Q

What are some of the revascularization options? (3)

A
3
Q

Describe the survival curve following pancreatoduodenectomy.

A
4
Q

What is being shown in this image?

A

Pancreatogastrostomy

5
Q

What are some of the familial pancreatic cancer risk factors?

A
6
Q

What is the median age of diagnosis?

A

72 y/o

7
Q

What procedure is this?

A

The whipple

8
Q

What are some of the genetic mutations associated with pancreatic cancer?

A
9
Q

What might determine surgical options and extent of resection?

A

Blood supply; the arterial supply is highly variable and dependent upon embryology, and venous follows arterial

10
Q

What is shown in these images?

A

Reconstruction

11
Q

What type of pancreatic surgery also requires splenectomy? It is technically simple, but is rarely ever an option for cancer.

A

Distal pancreatectomy

12
Q

What supplies blood to the following organs: stomach, liver, spleen, and pancreas?

A

GDA (gastroduodenal artery)

13
Q

What are some of the alternate names for pancreatoduodenectomy?

A

Whipple (US) and Kocher (Europe)

14
Q

What are the surgical steps to a PD? (6)

A
15
Q

What is important to note about this chart?

A

Hospitals that regularly perform PDs (>16/year) have significantly reduced mortality rates. As low as 4% as compared to 18%.

16
Q

What can be seen in the CT of the pancreas?

A

The double duct sign

17
Q

What is the incidence of pancreatic cancer?

A

10/100,000 in the US

18
Q

How often must the R hepatic artery be replaced?

A

15-20%

19
Q

How does the number of first degree relatives with familial pancreatic cancer increase the risk of developing pancreatic cancer?

A
20
Q

Describe the progression of the precursor lesions that lead to pancreatic cancer.

A
21
Q

What are some of the symptoms associated with pancreatic cancer?

A

Pain and Weight Loss

22
Q

Pancreatoduodenal arcades supply what type of circulation?

A

Collateral

23
Q

What is being done in these pictures?

A

Uncinate-SMA Dissection

24
Q

What % of pancreatic cancers are exocrine? What are some of the subtypes? The most common subtype?

A

98%; Adenocarcinoma

25
Q

What are some other risk factors for pancreatic cancer?

A

Chronic alcoholic pancreatitis (26x risk)

Obesity (20% higher risk)

African-American/Jewish/Hawaiian

26
Q

What imaging study is used as the gold standard for staging? (Also is the only needed test pre-op)

A

CT

27
Q

What percentage of pancreatic cancer is found as localized?

A

9%

28
Q

What % of pancreatic cancers are in stage IV/V?

A

80-90%

29
Q

What % of pancreatic cancers are endocrine? What are some of the subtypes?

A

2%

30
Q

Aside from distal pancreatectomy, what is surgical option for some pancreatic cancers?

A

Pancreatoduodenectomy

31
Q

What is the major risk factor for pancreatic cancer?

A

Cigarette smoking (2-3x higher risk)

32
Q

What imaging study is more sensitive than CT?

(Better staging and gold standard for tissue dx)

A

Endoscopic US

33
Q

Describe the pancreatic cancer survival curve using adjuvant chemo/rad tx

A
34
Q

What are the overall survival rates of pancreatic cancers?

A

1-yr survival: 8%

5-yr survival: 2%

35
Q

What are the 3 advantages of pancreatogastrostomy?

A

Enterokinase not available (proteolytic enzymes not activated)

Acidic gastric pH (reduces proteolytic activity)

Alkaline pancreatic secretions (protects against ulceration)

36
Q

What is the 5-year survival % of all stages of pancreatic cancer?

A

~ 7%

Decks in GI and Nutrition Class (57):