Pancreatic cancer is one of the common malignant tumors of the gastrointestinal tract and is the most common of all malignant tumors, occurring in about 70% of the head of the pancreas, followed by the body of the pancreas and even more so by the tail of the pancreas, some of which are found in the head, body and tail, and are diffuse lesions or multicentric lesions. The disease occurs in the middle-aged and elderly, male patients are far more pre-menopausal women, the incidence of post-menopausal women is similar to that of men. The cause of the disease is still unclear, the primary risk factors identified are smoking, diabetes gallstone disease alcohol consumption (including beer) and chronic pancreatitis, such as eating a high-fat, high-protein diet and refined flour foods, gastrectomy is also a risk factor for the development of pancreatic cancer, and its mortality rate is extremely high. Researchers believe that pancreatic cancer should be suspected in patients aged 40 years or older with any of the following clinical manifestations: (1) obstructive jaundice; (2) recent unexplained weight loss of more than 10%; (3) recent unexplained epigastric or low back pain; (4) recent indistinct and unexplained dyspepsia with a normal digestive tract on barium meal; (5) (5) sudden onset of diabetes without contributing factors, such as family history or obesity; (6) sudden onset of unexplained steatorrhea; (7) spontaneous episodes of pancreatitis. The suspicion should be doubled if the patient is a smoker. 2. Imaging The initial diagnostic test that should be selected is a CT scan. This scanner is not dependent on surgery, is not limited by the patient’s size or gastrointestinal gas, and can identify liver metastases, lymphatic lesions, and peripheral vascular invasion, but is not reliable for the diagnosis of damage smaller than 2 cm or small peritoneal nodules. ct can determine the stage of disease the patient is in and provide information in cases where surgery cannot be performed. If distant metastases, invasion of adjacent organs, encapsulation or invasion of blood vessels, and lymphatic lesions are found, the tumor cannot be surgically removed. However, CT is not precise enough for the diagnosis of resectable tumors. Percutaneous fine-needle aspiration biopsy can be performed under the guidance of CT, because the histological diagnosis needs to be determined, especially for inoperable patients. Clinical manifestations (1) Abdominal pain: It is an early symptom of pancreatic cancer, mostly seen in pancreatic body and tail cancer, located in the upper abdomen, around the umbilicus or right upper abdomen, and is colic in nature, paroxysmal or persistent, progressively aggravated dull pain, mostly radiating to the lower back, aggravated in lying position and at night, and can be relieved when sitting, standing, leaning forward or walking. (2) Jaundice: Jaundice can be present at a certain stage of the disease process, generally jaundice is more common in pancreatic head cancer and appears earlier, but not when the cancer is confined to the body and tail. Jaundice is mostly obstructive, progressive and deepening, accompanied by skin itching, urine color like strong tea, and feces of clay color. Most of them are caused by the compression of the common bile duct by cancer of the head of the pancreas, and a few are caused by metastasis of cancer of the body and tail of the pancreas to the liver or lymph nodes of the liver/general bile duct. (3) About 90% of patients have rapid and significant development of weight loss, which is often accompanied by malignancy in the advanced stage of pancreatic cancer. Causes of weight loss include depletion of cancer, loss of appetite, anxiety, insomnia, digestive and absorption disorders, etc. (4) Weakness and loss of appetite are very common, and may be accompanied by gastrointestinal symptoms such as diarrhea, constipation, abdominal distension and nausea. Some cases may develop steatorrhea and hyperglycemia, diabetes. If you do not like fatty dishes, you may also develop steatorrhea, which is a symptom of dysentery in which fat is not digested but mixed with feces and excreted. (5) Fever may also occur due to secondary bile duct infection as a result of cancer ulceration or infection. (6) Some cancers of the body and tail of the pancreas may cause thrombophlebitis in the veins of the limbs, resulting in localized swelling of the limbs. (7) Physical examination usually has no obvious signs in the early stage. In typical cases, emaciation, jaundice and epigastric pain can be seen. In the late stage, a nodular, hard mass may be palpated in the upper abdomen. If jaundice is accompanied by enlargement of the gallbladder, it is an important basis for pancreatic head cancer. Due to bile accumulation, enlargement of the liver can often be detected. If the cancer compresses the splenic vein or splenic vein thrombosis, splenomegaly can be detected. (8) In advanced pancreatic cancer, ascites may appear, and hard and enlarged metastatic lymph nodes may be found in the left supraclavicular or anterior rectal recess. (1) Surgery The success rate of surgery is low, only 15% for pancreatic head cancer and less than 5% for pancreatic tail, and the prognosis is disappointing even for early stage pancreatic cancer patients with complete resection. At present, short-term treatment for surgical purpose is to relieve symptoms and prolong life, and then consider how to cure. (2) Radiotherapy Any pancreatic cancer that cannot be resected radically can be an indication for radiotherapy, but the patient must have no functional damage to important organs such as heart, liver and kidney, no distant metastasis, and generally in fair condition with an estimated survival period of more than 3 months. Radiotherapy is divided into two types: internal radiotherapy and external radiotherapy. The dose of external radiotherapy is 60 Gy-65 Gy, while the dose of internal radiotherapy is 110 Gy-160 Gy. External radiotherapy has more side effects, while internal radiotherapy has less side effects. External radiotherapy is a non-invasive treatment with simple technique, while internal radiotherapy is an invasive treatment with difficult technique, and the treatment effect is directly related to the level of the surgeon. (3) Chemotherapy After surgery, adjuvant chemotherapy can be given, mainly based on gemcitabine, combined with other drugs, which can prolong survival.