最后审阅: 27 六月 2021
最后更新: 15 十月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 黄疸
  • 非特异性上腹痛或不适
  • 体重减轻和厌食

其他诊断因素

  • 年龄:65-75岁
  • 脂肪痢
  • 口渴、多尿、夜尿,以及体重下降
  • 恶心、呕吐、厌食,以及上腹部疼痛
  • 肝肿大
  • 腹部上腹部周围包块
  • Courvoisier's征阳性
  • 瘀斑、紫癜、青紫
  • 特鲁索征

危险因素

  • 吸烟
  • 胰腺癌家族史
  • 其他遗传性癌症综合征
  • 散发慢性胰腺炎
  • 糖尿病
  • 肥胖
  • 饮食因素

诊断性检查

首要检查

  • 腹部超声
  • 胰腺 CT
  • 肝功能检查 (LFT)

需考虑的检查

  • 凝血酶原时间 (PT)
  • 全血细胞计数 (FBC
  • 癌抗原 (CA) 19-9 生物标志物
  • 正电子发射计算机断层扫描
  • 经内镜逆行胰胆管造影术 (ERCP)
  • 磁共振胆管胰腺造影
  • 超声内镜
  • 腹腔镜分期(包括腹腔镜下超声
  • 活检

治疗流程

撰稿人

作者

Hemant M. Kocher, MBBS, MS, MD, FRCS

Professor of Liver and Pancreas Surgery

Barts Cancer Institute

Barts and The London School of Medicine and Dentistry

London

UK

利益声明

HMK is an author of a number of references cited in this topic. HMK has received trial funding from Celgene, advisory board honorarium from Baxalta Inc., and educational grants from Mylan, Celgene, Ethicon, and Medtronic.

鸣谢

Dr Hemant M. Kocher wishes to gratefully acknowledge Dr Fieke E.M. Froeling, a previous contributor to this topic. FEMF is an author of a reference cited in this topic.

同行评议者

Ross Carter, FRCS

Consultant Pancreatic Surgeon

West of Scotland Pancreatic Unit

Glasgow Royal Infirmary

Glasgow

UK

利益声明

Not disclosed.

Nikhil I. Khushalani, MD

Assistant Professor of Oncology

Roswell Park Cancer Institute

Buffalo

NY

利益声明

NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).

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