Pancreatic Cancer and Interventional Therapy

  Pancreatic cancer is a malignant tumor that occurs in the pancreas and is one of the common malignant tumors of the digestive system. It often involves the head of the pancreas (70% to 80%), can be solitary or multicentric, and is highly malignant and not easily detected at an early stage. The surgical resection rate is low and difficult to complete, and the 5-year survival rate after resection is only 5%.  Diagnosis of pancreatic cancer: Various examination methods can be used for the diagnosis and treatment follow-up of pancreatic cancer, with the following characteristics: (1) CT scan: Especially multi-row spiral CT is one of the preferred and reliable diagnostic methods, which can clarify the site and extent of the lesion, whether it is combined with metastasis of surrounding organs, lymphatic lesion and peripheral vascular invasion, determine the stage of the patient, and provide information for cases that cannot be operated. It can determine the stage of the disease and provide information in cases where surgery is not possible. However, the diagnosis of damage smaller than 2 cm or small retroperitoneal nodules is not reliable.  (2) Ultrasound: It is less expensive than CT and has higher sensitivity and specificity. It can be used as a supplement to CT examination.  (3) Magnetic resonance imaging (MRI): It is better to perform bile duct water imaging when combined with obstructive jaundice.  (4) Retrograde cholangiopancreatography (ERCP): better in the differential diagnosis of pancreatic cancer and obtaining tissue biopsy of duodenal and jugular cancer. It facilitates early diagnosis.  (5) Fine needle aspiration (FNA) under CT or ultrasound guidance: a better method to determine the histological diagnosis with higher accuracy.  Which pancreatic cancer patients are suitable for interventional treatment?  Patients at all stages, such as those who have difficulty in surgical resection, or those with more concomitant lesions that are not suitable for surgery, or those who are unwilling to undergo surgery or receive other methods of treatment, or those who have recurrence after surgery, can consider interventional treatment.  In addition, patients with intermediate to advanced pancreatic cancer, patients with obstructive jaundice, liver metastases, and severe back pain can also be considered.