Surgery in the patient with chronic hepatitis can create multiple dilemmas in the preoperative, perioperative, and postoperative phases. Preoperatively, assessment of the stability of the patient’s liver disease can be crucial in decisions regarding a surgical procedure (see Chapter 4…
Introduction Pancreatic and periampullary tumors are a common cause of cancer death, with rising incidence in the Western world. In 2018 the incidence of pancreatic cancer in the United States (US) was 13.7 per 100,000 persons, compared with 11.6 per…
Adjuvant chemoradiotherapy Early studies examining the role of external beam radiotherapy (EBRT) combined with 5-fluorouracil (5-FU) as a radio-sensitizing agent in advanced, unresectable, pancreatic adenocarcinoma identified increased median survival over radiotherapy alone. , One study published in 1979 by the…
Introduction Neuroendocrine tumors (NETs) represent a group of heterogenous neoplasms that originate from the diffuse neuroendocrine cell system, most commonly arising in the lung or gastrointestinal (GI) tract. Although NETs represent a rarer group of neoplasms, NET incidence and prevalence…
Introduction The pancreas is a rare site of distant metastasis. In 1950 in an autopsy study, Abrams et al. were one of the first to highlight the pancreas as a potential site for metastatic spread. Overall, these metastatic lesions constitute…
Overview Duodenal adenocarcinoma (DA) is a rare malignancy that accounts for less than 1% of all gastrointestinal (GI) cancers and occurs at a rate of less than 6 cases per million person years. In 2018 it was estimated that within…
Clinical presentation Pancreatic adenocarcinoma, or pancreas cancer, is one of the most lethal malignancies. While a relatively uncommon cancer, ranking 8th among cancer types in women and 10th in men, it is among the most common causes of cancer death…
Overview The pancreas, an organ located in the retroperitoneum, has both exocrine and endocrine functions. The exocrine pancreas is composed of duct cells and acinar cells that produce enzymes needed to break down carbohydrates, proteins, and lipids, thus promoting digestion.…
Introduction Cystic neoplasms of the pancreas have become a well-defined radiographic entity during the last decade. With the increasing use of cross-sectional imaging, the better quality of imaging modalities, and the aging population, the diagnosis rate has increased to an…
Tumors of the pancreatic duct or ductal-related origin Pancreatic intraepithelial neoplasia Pancreatic intraepithelial neoplasia (PanIN) is a noninvasive lesion confined to the pancreatic ducts and observed only microscopically (<0.5 cm). The mucin-containing duct epithelium exhibits a spectrum of architectural and…