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Diagnosis and Evaluation of Pancreatic and Periampullary Adenocarcinoma

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Hepato-Pancreato-Biliary Malignancies

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Abstract

Due to the serious nature of the disease, both pancreatic and periampullary cancers warrant heightened radiographic suspicion when signs and symptoms point to the disease. However, because the two diseases have separate biologies and significant differences in prognosis (in general, stage for stage, patients with ampullary cancers demonstrate longer survival rates compared with pancreatic cancers), it is incumbent upon the physician to make a timely, accurate diagnosis. Therefore, the objectives of this chapter are several fold. First, it aims to summarize the symptoms and risk factors of each disease, including a review of hereditary cancer syndromes. Next, it guides the reader into selecting the optimal diagnostic modality for each disease. Additionally, comparative effectiveness data comparing various types of biopsy modalities is presented. Finally, data on performance of staging CT/MRI/EUS is presented.

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Authors and Affiliations

  1. Kaiser Permanente, Baldwin Park Medical Center, Baldwin Park, CA, USA

    Daniel Lew

  2. Division of Gastroenterology, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA, USA

    Karl Kwok

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  1. Daniel Lew
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  2. Karl Kwok
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Correspondence to Karl Kwok .

Editor information

Editors and Affiliations

  1. Medical Director, Capital Health Cancer Center, Director, CH Pancreas Center of Excellence, Director, CH Liver Center of Excellence, Pennington, NJ, USA

    Cataldo Doria

  2. Director of Interventional Gastroenterology, Capital Health Medical Center, Pennington, NJ, USA

    Jason N. Rogart

1 Electronic Supplementary Material

Small PDAC in head of pancreas with abrupt cutoff of pancreatic duct and common bile duct (MP4 49538 kb)

Upper endoscopy identifying an ulcerated mass at the inferior wall of the gastric body with subsequent EUS revealing direct invasion from PDAC (MP4 71337 kb)

EUS-FNA of PDAC located in the body (MP4 51195 kb)

EUS-FNA of small PDAC (MP4 37617 kb)

EUS-FNA of ampullary cancer (MP4 27981 kb)

EUS showing PDAC in the body with splenic vein abutment and trace ascites (MP4 18442 kb)

EUS showing PDAC located in the uncinate with encasement of the superior mesenteric artery (MP4 94008 kb)

Liver metastasis and primary PDAC identified on EUS with tissue acquisition of both liver lesions and primary pancreatic lesion (MP4 130079 kb)

EUS techniques for evaluating the ampulla and ampullary mass (MP4 15516 kb)

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Lew, D., Kwok, K. (2022). Diagnosis and Evaluation of Pancreatic and Periampullary Adenocarcinoma. In: Doria, C., Rogart, J.N. (eds) Hepato-Pancreato-Biliary Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-030-41683-6_29

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  • Online ISBN: 978-3-030-41683-6

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