الفهرس 
EMBRYOLOGYOnly 14 pages are availabe for public view
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Abstract
The cause of pancreatic carcinoma remains unclear; there are many risk factors for developing pancreatic carcinoma as: tobacco smoking, high fatty meal, alcohol consumption, diabetes mellitus, pernicious anemia, chronic pancreatitis, cholelithiasis, gastric surgery, radiation and genetic factors. Pancreatic carcinoma is uncommon before the age of 45 years old; more than 80% of Patients are aged 60-80 years.
Approximately 90% of pancreatic exocrine tumors arise from pancreatic ductules and 80% of these tumors are adenocarcinoma, 60-70% arises in the head and the rest of the tumors located in the body, tail or diffusely throughout the gland.
Over 90% of patients with pancreatic carcinoma present in the late stage due to symptomatic tumor and vague complaint. Because of its deep seated inaccessible location the pancreas is difficult to visualize and investigate. There are many methods for pancreatic investigation as US, CT, angiography MRI, ERCP, endoscopic US, tumor markers as CA19-9, CEA, POA and fine needle aspiration cytology.
In more than 80% of patients the tumor is unresectable at the time of diagnosis. Surgical resection of pancreatic carcinoma offers the only chance for long-term survival. Over past 2 decades significant advances have been made in surgical techniques and preoperative care of the patient.
The operative management of pancreatic carcinoma involving head, neck and uncinate process consists of 2 phases, first assessing the tumor resectability and then if the tumor is resectable a pancreaticoduodenectomy and restoring gastrointestinal continuity takes place. Adjuvant chemoradiotherapy like: 5-florouracil and gemcitabine improve the results of surgery.
Surgical palliation of unresectable pancreatic tumors can improve the quality of life of these patients. Surveillance and screening of high risk groups by effective and cost-effective methods will improve the detection of precancerous lesions thus improving the prognosis.
Prognosis of pancreatic cancer is generally bad even with resected cancer.