胰腺疾病 中山大学 内科学.ppt

LING YUNBIAO Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University 凌云彪 中山大学附属第三医院肝胆外科 PANCREASPANCREAS The chapter includes: Summary of anatomy the others or more than 3- 6m, surgical drainage lpancreatic abscess - surgical drainage Chronic Pancreatitis Pancreatic Cyst PeriampullaryPeriampullary Carcinoma Carcinoma lcarcinoma of head of pancreas lampullary carcinoma duodenal papillary carcinoma carcinoma of distal common bile duct carcinoma of Vaters ampulla Symptoms and signsSymptoms and signs upper abdominal pain (vague severe, back pain) 70 jaundice (painless) 80% weight loss 75 Trousseaus syndrome, Courvoisiers sign others: nausea, vomiting, anorexia, steatorrhea, panceatitis, changes of stools, diabetes mellitus, etc Blood test l bilirubin, alkaline phosphatase , , transaminase l CA19-9,CEA PeriampullaryPeriampullary Carcinoma Carcinoma Imaging studiesImaging studies l ultrasound (initial) l BM barium meal l CT l ERCP l PTCD l MRI, MRCP l angiography l EUS endoscopic ultrasonography Surgical procedures lWhipple procedure, pancreatoduodenectomy lPPPD, pylorus-preserving pancreatoduodenectomy lPalliative surgical management CHJ，cholangiojejunostomy gastrojejunostomy celiac plexus block endocrine tum