Surgery of Pancreatic Disorders Flashcards Preview

07. Year 2: Alimentary System > Surgery of Pancreatic Disorders > Flashcards

Flashcards in Surgery of Pancreatic Disorders Deck (95)
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1

What are examples of pancreatic disorders?

Pancreatic cancer

Acute pancreatitis

Chronic pancreatitis

Intraductal papillary mucinous neoplasm (IPMN) and pancreatic cystic disease

 

2

What does IPMN stand for?

Intraductal papillary mucinous neoplasm

3

What is the incidence of pancreatic cancer in the UK?

10/100000

4

What age group is pancreatic cancer most common in?

60-80 years old

5

What is the male:female ratio of pancreatic cancer?

3:4

6

What is the 5 year survival rate of pancreatic cancer?

0.4%

7

What are risk factors for pancreatic cancer?

Smoking

Chronic pancreatitis

Adult onset of diabetes

Hereditary pancreatitis

Inherited predisposition

8

What is the presentation of pancreatic cancer?

Obstructive jaundice

Diabetes

Abdominal pain/back pain

Anorexia

Vomiting

Weight loss

Recurrent bouts pancreatitis

9

What investigations are done for pancreatic cancer?

Blood tests

Chest x-ray

Tumour markers (CA19-9)

Imaging/invasive investigations

 

10

What antigen is released by cancerous pancreatic cells that can be tested for?

CA19-9

11

What imaging/invasive tests can be done to investigate pancreatic cancer?

CXR

USS

CT

MRCP

Laparoscopic USS

Peritoneal cytology

Percutaneous needle biopsy

PET scan

12

What is considered when considering if a patient with pancreatic cancer is fit for pancreatic resection?

Basic history and examination

Chest x-ray and ECG

Respiratory function tests

Physiological scoring system

 

13

What types of surgery can be done for pancreatic cancer?

Kausch-Whipple

Pylorus-preserving pancreaticoduodenectomy (PPPD)

Palliative drainage

Metal stenting

14

What does PPPD stand for?

Pylorus-preserving pancreaticoduodenectomy

15

What is a pylorus-preserving pancreaticoduodenectomy

Similar to Whipples operation but none of the stomach is removed

16

What is Kausch-Whipple surgery?

Removes head of pancreas, bile duct, gallbladder and the duodenum

17

What is Kausch-Whipple surgery also known as?

Pancreaticoduodectomy

18

What is acute pancreatitis?

An acute inflammatory process of the pancreas with involvement of other regional tissues or remote organ systems

19

What are the different classifications of acute pancreatitis?

Mild AP

Severe AP

20

What is mild acute pancreatitis associated with?

Minimal organ dysfunction and uneventful recovery

21

What is severe acute pancreatitis associated with?

Organ failure or local complication

22

What are some local complications of acute pancreatitis?

Acute fluid collection

Pseudocyst

Pancreatic abscess

Pancreatic necrosis

23

What is the aetiology of acute pancreatitis?

Gallstones

Alcohol

Viral infections (CMV, mumps)

Tumours

Anatomical abnormalities

ERCP

Lipid abnormalities

Hypercalcaemia

Postoperative trauma

Ischaemia

Drugs

Scorpion venom

Idiopathic

24

What viral infections can cause acute pancreatitis?

CMV

Mumps

25

What does CMV stand for?

Cytomegalovirus

26

What is the pathophysiology of acute pancreatitis caused by alcohol?

Direct injury

Increased sensitivity to stimulation

Oxidation products (acetaldehyde)

Non-oxidative metabolism (fatty acid ethyl esters)

27

What is the pathophysiology of pancreatitis caused by gallstones?

Passage of gallstone is essential

Raised pancreatic ductal pressure

28

What is the pathophysiology of acute pancreatitis caused by ERCP?

Increased pancreatic duct pressure

29

What are some symptoms of acute pancreatitis?

Abdominal pain

Nausea, vomiting

Collapse

30

What are some signs of acute pancreatitis?

Pyrexia

Dehydration

Abdominal tenderness

Circulatory failure