Peripancreatic cancer

　　The etiology of this disease is not yet clear and may be related to many factors. When there is no metastatic focus and the general condition allows, a primary pancreaticoduodenectomy can be performed. In a good pancreatic surgery center, the mortality rate of surgery is about 1-2%. The vast majority of patients die of tumor recurrence after surgery, with recurrence within three months after surgery often indicating poor prognosis.

　　In addition to general symptoms, it may cause other diseases. This disease often occurs with toxic shock, secondary anemia, ascites due to peritoneal metastasis or portal vein metastasis of pancreatic cancer. Therefore, once detected, active treatment should be carried out, and preventive measures should also be taken in daily life.

　　Progressive, painless jaundice, occasionally due to tumor necrosis, recanalization of the bile duct, and presents fluctuation, long-term bile stasis can lead to cholestatic liver cirrhosis, gallbladder enlargement, and in patients with concurrent biliary tract infection, there may be high fever, chills, and even toxic shock. Abdominal pain is generally not severe, sometimes spreading to the back, gastrointestinal dysfunction, clay-colored stools, generalized itching, poor appetite, diarrhea, and weight loss.

　　In a good pancreatic surgery center, the mortality rate of surgery is about 1-2%. The vast majority of patients die of tumor recurrence after surgery, with recurrence within three months after surgery often indicating poor prognosis. The size of the tumor, the condition of lymph node metastasis, the involvement of large blood vessels, the condition of nerve involvement, the differentiation grade of tumor cells, the margin of tumor resection, and blood transfusion during or after surgery are all related to prognosis.

　　1, Laboratory examination:Early amylase levels may increase, serum bilirubin is generally above 13.68μmol/L (8mg), and about 85-100% of patients have positive occult blood in stool tests, microscopic examination can see undigested muscle fibers and fat, and there may be glucose in the urine.

　　2, Duodenal drainage:Sometimes fresh blood or occult blood can be seen in the drainage fluid, or there may be shed cancer cells.

　　3, X-ray examination.

　　4, Gastrointestinal barium meal and duodenal hypotonic contrast examination.

　　5, PTC:It can show the blocked location at the lower end of the common bile duct, and attention should be paid to complications such as bile leakage and cholestatic peritonitis.

　　6, ERCP:It can observe the inner wall of the duodenum and the papilla, and can also perform biopsy and confirm the diagnosis, which is of great help in the diagnosis of ampullary cancer and pancreatic head cancer (which may have pancreatic duct stenosis or non-shadowing, etc.).

　　7, Selective mesenteric angiography:Beneficial for the diagnosis of pancreatic head cancer, changes in blood vessel position can indirectly determine the location of pancreatic cancer.

　　8, CT:It is significant for the diagnosis of pancreatic head cancer, helpful for the diagnosis of the disease, and can show the location and outline of the tumor.

　　9. Ultrasound:Can determine bile duct dilation, and can also provide early clues for further examination for those without jaundice.

　　10. Radionuclide examination:Can understand the obstruction site.

　　Food Therapy Recipe

　　Steamed mandarin fish with Poria cocos:Firstly, prepare 15 grams of Poria cocos, 1 fish, and appropriate amounts of scallion and ginger. Grind Poria cocos into fine powder, then make several incisions on the cleaned fish, cut the ginger and scallion into strips for later use. Next, apply the Poria cocos powder evenly on the fish and inside the fish belly, cover the fish with ginger and scallion strips. This completes the preparation for steaming Poria cocos with mandarin fish. Then, steam the prepared fish over high heat for 10 minutes. Remove the fish from the pot, add some soy sauce to the juice from the steamed fish into a small pot, add some salt according to taste, mix well, and pour it over the fish. This dish of steamed Poria cocos with mandarin fish is now ready to eat.

　　Firstly, surgical treatment

　　For those with clear or highly suspicious diagnosis and no metastasis found in clinical examination, abdominal exploration should be performed.

　　For those without metastatic foci and with overall condition allowing, perform a pancreatoduodenectomy in one stage. For those with poor physical condition, consider PTCD or cholecystojejunostomy, and perform a second-stage pancreatoduodenectomy after jaundice subsides.

　　For those with cancer infiltration into adjacent organs or distant metastasis, only perform cholecystojejunostomy or cholecystoduodenostomy to relieve jaundice.

　　Secondly, non-surgical treatment

　　1. Symptomatic Treatment:Take oral multi-enzyme tablets, vitamins, and protein. Blood transfusion, fluid replacement, pain relief.

　　2. Chemotherapy:For comprehensive treatment before and after surgery or for those who cannot be operated on. Fluorouracil 250-500mg/day, intravenous infusion, total dose of 7.5-1.0g for one course, rest for 2-4 weeks after which to repeat. Combined chemotherapy, administer mitomycin 4mg, arabinosylcytosine 100mg, fluorouracil 500mg, add to 10% glucose solution, twice a week, intravenous infusion, 10 times for one course. Check blood count every 5-7 days during medication, if white blood cells are below 3.5×10^9/L and platelets are below 8×10^9/L, discontinue medication.

　　3. Traditional Chinese Medicine Treatment.

　　4. Immunotherapy:Thymosin, interferon, and transfer factor can be used.