CT scan is the single most important and cost-effective imaging
modality in diagnosing and staging of pancreatic Ca. The accuracy
of CT scan in predicting unresectable disease is 90%-95%. In
contrast, it is less accurate in predicting resectable disease.
MRI: cost-prohibitive
PET-not recommended
There are multiple modalities for evaluation of pancreatic Ca
including CT scan, EUS, laparoscopy, tumor markers, MRI, biopsy
and laparoscopy. Patients do not require tissue biopsy prior to
resection.
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preoperative staging of Asymptomatic pancreatic
pancreatic cancer pseudocyst
location of ucinate process Somatostain + glucagon causes
Grading pancreatic injuries Lymphatic nodes of pancreas
Don't know?
4 of 96
Definition
-Know which blood supply is affected based on the
grade of injury
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formation of portal vein primary pancreatic lymphoma
Grading pancreatic injuries Chronic Pancreatitis
, Don't know?
5 of 96
Definition
1. U/S- need to check for gallstones
2. CT- check for complications (necrotic pancreas- which will not
take up contrast from CT)
Tx: NPO, NGT, aggressive fluid resuscitation
ERCP not needed in pts with gallstone pancreatitis (stone passes on
its own) -> pt will need lap chole
[Exception: pt with severe gallstone pancreatitis w/ fluid
collections/pseudocysts -> wait 6 weeks for lap chole
Abx: (Imipenem- best) for severe pancreatitis
NG or nasoduodenal tube feeds should be started within 24-48HRS
of severe pancreatitis.
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