Pancreatic cancer is a highly aggressive digestive system tumor, the incidence of which is increasing year by year in China, with difficult early diagnosis, low surgical resection rate and poor prognosis. 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. we must be alert to these symptoms of pancreatic head cancer. I. Clinical manifestations There are no specific symptoms in the early stage of pancreatic head cancer, and most of the clinical symptoms are already in the middle and late stage. 1. Upper abdominal pressure pain is the only physical sign of pancreatic head cancer in early stage. As the disease progresses, the pain will be aggravated by the pulling reaction caused by the visceral peritoneum. 2.Gallbladder enlargement Jaundice with palpable enlarged gallbladder is the main sign of pancreatic head cancer. 3.hepatosplenomegaly About 70% of patients have hepatomegaly due to hepatic stasis. If the splenic vein is blocked by cancer clots, splenomegaly can be detected. 4.Abdominal mass Because the pancreas is deeply hidden in the back of the abdominal cavity, it is generally not easy to palpate the cancer itself, but in advanced pancreatic head cancer, a fixed, hard nodular mass can be found during deep palpation. 5.Vascular murmur in the abdomen When pancreatic head cancer compresses the superior mesenteric artery, abdominal aorta or splenic artery, wind-like vascular murmur may appear in the abdomen. 6.Sign of ascites At the advanced stage of pancreatic head cancer, due to peritoneal metastasis, portal vein thrombosis or compression of portal vein by cancer, there may be the sign of ascites. 7.Thrombophlebitis Patients with pancreatic head cancer may have wandering thrombophlebitis or deep vein thrombosis in the lower leg. 8.Lymph node enlargement The onset of pancreatic head cancer is relatively insidious, and when patients present symptoms, such as hidden abdominal pain, jaundice and weight loss, they will seek medical consultation. The prognosis of pancreatic head cancer is quite poor, and whether to operate or not does not improve the survival rate much, and chemotherapy is relatively insensitive, so the prognosis is quite poor. Diagnosis Most patients have elevated tumor markers, such as CA19-9 and CEA. Imaging examination is an important tool for the localization and qualitative diagnosis of pancreatic head cancer, ultrasound is a screening tool, imaging mainly relies on thin layer enhanced CT and MRI, and invasive examinations such as ultrasound endoscopy and ERCP are feasible when necessary. If the diagnosis is unknown, such as pancreatic head mass type pancreatitis, fine needle aspiration cytology examination under ultrasound endoscopy is feasible. Treatment At present, the treatment of pancreatic head cancer mainly includes surgery, radiotherapy, chemotherapy and interventional therapy. Surgery is the first choice of treatment for pancreatic head cancer. For pancreatic head cancer without distant metastasis, radical surgical resection should be pursued. Commonly used surgical methods include pancreatic head duodenectomy, extended pancreatic head duodenectomy, pylorus preserving pancreatic head duodenectomy (PPPD), total pancreatectomy, etc. Palliative surgery is suitable for patients with advanced age, liver metastases, unresectable tumor or combined with significant cardiopulmonary dysfunction who cannot tolerate larger surgery, including biliary-enteric anastomosis to relieve biliary obstruction and gastrojejunostomy 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, a combination therapy based on radiotherapy is feasible.