Pancreatic head cancer Disease introduction: Pancreatic cancer is a highly aggressive digestive system tumor, the incidence rate is increasing year by year in China, early diagnosis is difficult, surgical resection rate is low, and the prognosis is poor. The malignant tumor occurring in the head of pancreas is called pancreatic head cancer, which accounts for about 2/3~3/4 of pancreatic cancer. Clinical manifestation: Pancreatic head cancer has no specific symptom in early stage, and most of the patients with clinical symptom have already belonged to the middle and late stage. Some patients will take diabetes as the first symptom. Obstructive jaundice caused by biliary tract obstruction of pancreatic head cancer is the most common symptom, and a few patients can be combined with biliary tract infection with chills and high fever, which is easy to be confused with cholelithiasis. If it causes duodenal obstruction, nausea and vomiting, difficulty in eating, malignant fluid and other symptoms can also appear. Diagnosis: Tumor markers, such as CA19-9 and CEA, can be elevated in most patients. Imaging examination is an important means for localization and qualitative diagnosis of pancreatic head cancer. Ultrasound is a screening tool, and imaging mainly relies on thin-layer enhanced CT and MRI, and invasive examinations such as ultrasound endoscopy and ERCP are feasible when necessary. When the diagnosis is not clear, such as pancreatic head mass type pancreatitis, fine needle aspiration cytology under ultrasonic endoscopy is feasible. Treatment: Currently, the treatment of pancreatic head cancer mainly includes surgery, radiotherapy, chemotherapy and interventional therapy. Surgical resection is the first choice of effective treatment for pancreatic head cancer. For pancreatic head cancer without distant metastasis, radical surgical resection should be pursued. Commonly used surgical methods include pancreaticoduodenectomy, extended pancreaticoduodenectomy, pylorus-preserving pancreaticoduodenectomy (PPPD), total pancreatectomy and so on. Palliative surgery is suitable for patients who are old, have liver metastases, have unresectable tumors or combined with obvious cardiopulmonary dysfunction that cannot tolerate larger surgeries, including bile-intestinal anastomosis to relieve biliary obstruction and gastrojejunal anastomosis to relieve duodenal obstruction. Systemic chemotherapy is used for postoperative adjuvant treatment or locally advanced unresectable pancreatic cancer cases with distant metastases. For patients with unresectable tumors, comprehensive treatment based on radiotherapy is feasible. Characteristics of our department: With the goal of “improving radical resection rate, prolonging patients’ life and improving quality of life”, our department vigorously carries out various radical surgeries for pancreatic cancer, including enlarged pancreaticoduodenal radical resection, combined vascular resection and reconstruction, pancreaticoduodenectomy with pylorus preservation, etc., and adopts the comprehensive treatment with radiotherapy and chemotherapy for the patients with locally advanced pancreatic cancer, which has achieved good results, For patients with locally advanced pancreatic cancer, radiotherapy and chemotherapy have been adopted, which have achieved better clinical efficacy. At present, the resection rate of pancreatic head cancer in our department is at the advanced level in China. A 91-year-old female patient was admitted to the hospital because of “pain in the middle and upper abdomen, poor appetite for a week, accompanied by yellowing of the skin and sclera”, and ultrasound showed that the pancreatic head was occupied, and the bile duct was dilated, which was diagnosed as “tumor of the head of the pancreas”. He was diagnosed as “pancreatic head tumor”. After preoperative PTCD drainage to reduce yellowing, nutritional support and comprehensive evaluation, pancreaticoduodenectomy was successfully performed for the patient, and the patient was discharged from the hospital 3 weeks after the operation, with no recurrence after one year of follow-up.