胰腺疾病(英文)答题.pptVIP

慢性胰腺炎 Medical therapy Alcohol and cigarette avoidance Analgesics 镇痛 Enzyme therapy Treatment of malnutrition Surgical therapy Biliary Obstruction, pancreatic pseudocysts, combined with biliary diseases, intractabe pain, Celiac nerve block （难处理） Therapeutic endoscopy 胰腺肿瘤 Pancreatic carcinoma Arise from acinar腺泡 or duct cells Early diagnosis very difficulty , prognosis poor Obstructive jaundice(permanent):main symptom Abdominal pain Diabetes Weakness, emaciation(消瘦) Stools: acholic无胆汁 Gallbladder:Distended Abdominal mass Diagnosis of pancreatic carcinoma Laboratory test: AKP ,r-GT,LDH;CEA ,POA胰胚抗原, PCCA胰癌相关抗原,CA19-9 Imaging finding US,CT( CTA),MRCP ERCP, PTCPTCD PET(正电子发射断层扫描) Biopsy(FNA) and cytology 胰腺肿瘤 Treatment of pancreatic carcinoma Radical operation Pancreatoduodenectomy ---- tumor in pancreatic head Resection of pancreatic body and tail---tumor in pancreatic body or tail Palliative operation: to relieve jaundice Biotherapy 胰腺肿瘤 SPN 胰腺密度 胰腺肿瘤密度低于胰腺密度 Pancreatic endocrine neoplasm(PEN) Insulinoma Arise from B cell Symptoms: whipple’s triad 1 Spontaneous hypoglycemia accompanied by central nervous system, psychiatric,or vasomotor symptoms 2 Repeated blood sugar levels below 2.8mmol/L(50mg%) 3 Relief of symptoms by oral or intravenous administration of glucose Diagnosis: symptom and IRI/G0.3,B-us,CT,MRI, Endo-US,Angiography,PTPS Treatment:operation(resection) 胰腺肿瘤 Arise from: Papilla of duodenum Vater ampulla Distal CBD Symptom: obstructive jaundice Diagnosis Treatment :similar to pancreatic carcinoma 壶腹周围癌 胰腺疾病 解剖生理概要 解剖 头，颈，体，尾，钩突。 主胰管 (duct of Wirsung) 副胰管 (duct of Santorini) 胰腺分泌 外分泌Exocrine 内分泌Endocrine B,A,D,D1,G cell c Causes Gallstones:60%( 35–50% in USA) Alcohol:14% %(60% in USA) Duodenal juice countercurrent flow: Sphincter of Oddi dysfunction Trauma Pancreas circulation disorder Other factors: Drug: Azathioprine(硫唑嘌呤)?.6-Mercaptopurine(6-巯基嘌呤), Pancreas divisum(胰分裂), Microlithiasis