Valery Zolotov

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A.

Cancer Pheterova Pacific is a common oncological disease. It occurs at about twenty percent of all diagnosed tumors on the gastrointestinal bodies.

This neoplasm appears from the epithelial tissue of the mucous membrane on the duodenum. It may also appear from the overall epithelium of bile and pancreatic ducts and fauters papilla.

Features and symptoms of tumor

Basically, the tumor does not go beyond their limits, in addition to cases when infiltrative cancer is installed. In this diagnosis, the neoplasm will grow further, hitting the neighboring organs and lymph nodes. May result in adenocarcin.

10-foot papillars

In 25% of patients with this disease there are metastases, affecting lymph nodes and liver.

The disease is characterized by well-pronounced symptoms. The availability of the disease serve:

• in 75% of cases, mechanical jaundice is observed;
• stupid it's a dull pain In the area of \u200b\u200bthe epigastric area, which gives in the back. But this is typical for later stages;
• heat;
• liver colic;
• diarrhea;
• obstruction of the grocery gland duct;
• the presence of blood in feces;
• tumor bleeding;
• dyspepsia;
• anorexia;
• skin itch;
• nausea, vomiting;
• weight loss.

Stages of development of the tumor

Depending on the number and degree of development of signs, lesions internal organs, characterize the stage of the disease and possible sorry.

At the time of the diagnosis of the stage of development of the disease in a variety of cases of operational, although the lifespan after the operation is only five years and then, only 40%.

1. on 1 there is a primary neoplasm in the ampoule area of \u200b\u200ba duodenal nipple. Regional and remote metastases are detected;
2. for the 2nd stage, the distinctive invasion of the pancreas tumor and duodenal gut About two centimeters, remote and regional metastases are absent;
3. the third stage of cancer in the patient is characterized by a strongly pronounced tumor. It is located in the ampoule of the nipple and the sphincter apparently. Invasion of duodenal and pancreas in volume up to 2 cm. Metastases in regional lymph nodes are present;
4. for characteristic invasion of duodenum, pancreas, and all other organs, which are located next to more than two centimeters. In lymph nodes there are developed regional and remote metastases.

With the appearance of the first symptoms of the disease - a mechanical jaundice - the base is most of all, heredity works, if you feel more accurate, then the family type of polyposis.

Another reason is pancreatitis, especially in the launched form. Provice the appearance of the disease can affect the body into the body, the spread of it on the duodenum. This can contribute to the appearance of cancer cells in the duodenal nipple area.

Recently, the diseases of biliary tract have become more frequent, which can also serve as a prerequisite for inflammation and development of cancer cells, a large number of different cysts appear, as well as salt sediments.

Diagnostics

In progressive medicine, this type of cancer is diagnosed with the use of known methods of inspection of internal organs. They are conducted to identify the presence of cancer cells, tumors.

At the beginning of the diagnosis, anamnesis is going, underway clinical researches, blood and urine test.

To confirm the symptoms and suspicion of cancer, deployed blood tests are carried out. They are held oncomarkers and during them there is a fence of pancreatic enzymes.

The final action in the diagnosis should be examined by ultrasound abdominal cavity. Thus, the identification of possible anomalies is carried out. To determine the size of the tumor, the stage of development of the disease, computed tomography of the abdominal organs is prescribed. Laparoscopic, endoscopic ultrasonography is prescribed in extreme situations.

Before determining which stage is cancerThe biopsy of the neoplasm is carried out. If necessary, histopathology and histochemistry of the material taken are appointed.

Another additional study is magnetic healing cholangiopancratography. It serves to find out how symptoms of cholangitis occur in the later stages.

Treatment of Cancer Faterova Pacific

When establishing a diagnosis, the stage of the development of the disease is determined, and appropriate treatment is prescribed. In some cases, their action is focused solely on the weakening of the signs of the disease and the improvement of the quality of life of the patient, if we are talking about the 4 stage of the disease.

Woods of Faterava Packet

To cure a malignant neoplasm, pancreatododenal resection is mainly carried out, in other words, surgical intervention, during which affected areas are removed.

During resection, removed:

1. part of the stomach of significant size;
2. segment of the small intestine;
3. gall-bubble;
4. part of the total bile duct;
5. head and cervical pancreatic;
6. regional lymph nodes.

This method makes it possible to achieve 40% survival in cancer patients for the period up to 5 years, subject to the absence of metastases. If they were discovered, which happens in twenty percent cases, the survival of patients is reduced to 10%.

These characteristics are extremely small and confirm the severity of the disease. The price of resection (Wipple operations) is depending on the stage of cancer and the presence of metastases.

The cure of the surgical method is considered the most effective. It can be carried out in combination with radiation therapy. As for chemotherapy, it is ineffective with this species of cancer.

Chemotherapy is prescribed in rare cases and the following drugs are used for it:

• iphosfamide and Mitomycin together with Formuracyl;
• formuracyl and Cisplastin.

The price of such a course of treatment is within 5,000 rubles for one-time receipt of chemicals. They are used depending on the stage of the disease.

Radiation therapy is focused on relief tumor growth. And it is effective only in thirty percent of cases. More effect can be achieved by radiotherapy to lower pain syndrome.

The course of treatment includes several sessions. radiation therapy, the number of which is set by the prescribed doctor.

The treatment of patients with cancer is engaged in four main specialists. These include oncologist, radiologist, gastroenterologist, surgeon.

The life expectancy of patients is largely depending on the activities of these doctors, proper diagnosis.

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Cancer Fanthersova Nipple can be (1) primary(as a result of the development of sarcoma, carcinoid or adenocarcinoma in it (90% of tumors of the Nipple Tumor)) and (2) secondary(due to the spread of duodenal tumors on it).

The exact causes of the disease are not installed. In patients with family polyposis, the risk of developing the Cancer of the Nipple Cancer was elevated. The likelihood of the disease can affect the mutations of the K-RAS gene. Every year about 2 thousand new cases of carcinomas are registered in the world, make up 0.2% of all malignant gastroy tumors.

Classification of Cancer Nipple Cancer. TNM Cancer Cancer Cancer Nipple . T - tumor. T0. - There is no primary tumor. TIS. - Carcinoma in situ. T1.- The tumor is located in ampoules or sphincter Oddi. T2. - Invasion duodenal tumor. T3.- Invasion pancreatic tumor is less than 2 cm. T4.- invasion of pancreatic tumor and other nearby organs by more than 2 cm. N - Regional lymph nodes. N0. - There are no metastases in regional lymph nodes. N1. - metastases in regional lymph nodes. M - remote metastasis. M0. - No distant metastases. M1. - Remote metastasis. Stage of Cancer Fatera Nipple . Stage I: T1, N0, M0. Stage II: (T2, N0, M0); (T3, N0, M0). Stage III : (T1, N1, M0); (T2, N1, M0); (T3, N1, M0). Stage IV: T4, any N, any M.

Maintenance clinical manifestations Cancer Fatera Spa: Mechanical jaundice (in 75% of cases), skin itching, anorexia, dyspepsia, vomiting, loss of body weight, blunt pain in the epigastric area (in the late stages of the disease they are irradiated in the back), an increase in body temperature (with accompanying cholangitis). In the obstruction of the pancreatic duct, diarrhea is observed. In the occurrence of bleeding from the tumor, blood appears in the patient chair.

Diagnostics. Collecting Anamnese and Physical Research . Laboratory diagnostic methods . General analysis blood(There may be normal anemia, leukocytosis, SE acceleration). Coagulogram (can increase or decrease prothrombin time; there is an increase in the time of bleeding and blood coagulation). Biochemical analysis blood(During the obstruction of the biliary tract, the content of bilirubin (conjugated), the activity of aspartataminotransferase and alaninotransferase) can increase. Determination of tumor markers(An increase in the content of Ca 19-9 antigen, carcinoembrium antigen (CEU), DU-PAN-2 antigen, alphahaphhetoprotein, pancreatic oncofetal antigen (Poa)) is found. Kala Analysis (blood can be detected in the patient chair with ulcene or bleeding tumors; with a long existing obstruction of the biliary tract, there is a discoloration of a feces or the acquisition of silver-white ("silver" chair)). Urine tests (bile pigments may be detected; with complete obstruction of the biliary tract in the urine there is no urobinogen). Instrumental research methods . Transabdominal ultrasonography(Allows you to visualize the expansion of bile ducts, metastases in the liver (in 90% of cases), ascites, regional metastases; in 90% of patients, it is possible to set the level of obstruction; the sensitivity of the method is 80-90%). Endoscopic ultrasonography(allows you to identify tumors up to 1 cm) and laparoscopic (You can detect metastases into the liver and on the peritoneum; carry out the tumor staging). CT abdominal cavity(The study accuracy is 90%; allows you to test the tumor and evaluate its rectaging; it is impossible to detect damage to 1 cm). MRI abdominal cavity(The accuracy of the study is 94%; allows you to conduct the staging of the tumor and evaluate its rectaging). Endoscopic retrograde cholangogeadography (This study allows you to identify the level and degree of obstruction of the biliary tract; detect tumors to 1 cm; during its implementation, you can perform stenting and drainage of the biliary tract; to produce a biopsy). Percutaneous transgusting cholagngiography (It is carried out in case of the impossibility of performing endoscopic retrograde cholangogeagatography). Biopsy tumor (performed in the preoperative period; approximately 90% of cases are detected adenocarcinoma).

Differential diagnosis . Fasta Nipple Cancer should be differentiated from diseases such as the stricture of the biliary tract, cholangicocarcinoma, bile disease, non-Hodgkinsky lymphoma, pancreatic cancer, chronic pancreatitis.

Treatment - surgical. Approximately 20% of patients during the operation are detected metastases in lymph nodes and other organs; 5-year survival is 5-10%. In the absence of metastases, pancreatododenal resection (Operation of Wipple) allows you to achieve five-year survival in 40% of patients. Chemotherapy Cancer Cancer Nipple is ineffective. Combinations of fluorouracil, iphosphamide and mitomycin are used; Formuracyl and cisplatin.

Forecast. At the I stage of Cancer Paterov Nipple 76% of patients live up to 5 years. With II and III, the 5-year survival rate is observed in 17% of patients.

Prevention. Specific prevention measures do not exist. Of particular alertness should be considered to patients suffering from the family form of polyposis.

The patient, 42 years old, by profession the economist, entered us with complaints about jaundice, sharp itching of the skin, weakness and alliance. Over two and a half months old. The disease began unnoticed: jaundice appeared, which the surrounding patients said.

Since then, jaundice has progressed, then other phenomena also joined. Temperature is normal all the time. At first, despite the jaundice, continued to work, but weakness increased significantly; I had to leave work. Cal is dedicated, gray, urine saturated yellow. The patient does not drink, does not smoke. During the disease, I was noticeably stuck. Before that disease was always healthy.

The man has 42 years old, quite healthy, in good condition, surrounding unexpectedly for him noticed jaundice. This circumstance is important evidence that no subjective disorders felt.

But appearing, the jaundice relatively quickly reaches a large intensity and keeps soy. And only some time after her appearance, the patient began to feel weakness, itching throughout the body, and, in the end, was forced to quit work.

Of all the stories, we are interested in one of the main symptoms - jaundice. We have already disassemble the question of origin different species Jaundice and now we can only say that the discolored Cal testifies to the full blockage in the field of bile outlet.

"Hospital therapy", A.S. Voronov

Where is this tumor? It should be sought there, where the grade of the duct causes a complete blockage of the selection of bile, that is, at the place of the shared bile duct in the duodenum, most likely - in the fare nipple, or in the pancreatic head, where it squeezes bile duct. On the other hand, the same picture of jaundice in rare cases can ...

Functional liver tests: Takata-Ara - (n - negative); Kwick's sample - 65% (N - 70-80%). There are many bilirubin in the urine, since on the urine border with a one-interest iodine, a wide clear green ring is visible. Urobilin is absent in the urine. In the feces, with a subcobilline subcommunication reaction. Blood: Erythrocytes - 3,400,000, hemoglobin - 1-70 units, color indicator ...

The differential feature that distinguishes the Cancer Nipple Cancer from the pancreas head to consider the intermittent jaundice in the first case and constant with a cancer, emanating from the pancreatic head. Fats of the nipple of very small diameter, and a small breakdown of the tumor can already contribute to the patency of bile. To establish a diagnosis of Cancer Cancer Nipple or Pancreas Heads great importance In the clinic attached ...

Despite the fact that there is a lot of data in favor of cancer, it is impossible to finally reject the idea of \u200b\u200bsyphilis. Therefore, first of all, test antisifilitic treatment should be carried out. The patient is appointed Bietovo medicine. Applying it for two weeks did not give any effect. It finally convinced us in the correctness of the diagnosis. But since there are no 100% of the data in favor of the tumor, ...

But another patient, employee, 32 years old. Sick 11.VIII. The temperature has increased to 37.8 °, overall malaise, nausea, belching, constipation, poor appetite. The first days continued to work. Up to 23.viii temperature rose; From 23.VIII has become normal. At that time, noted the jaundice, which: quickly increased in intensity. Approximately a week later, Cal became discolored. When studying at this time, there was a common ...

An examination by the end of the second month from the beginning of the disease revealed a markedly increased smooth, somewhat compacted liver, protruding on four transverse fingers from the hypochondrium. But it is especially important - a large, smooth, elastic formation, a slightly painful in pressing and movable with breathing, discovered in the field of the right lobe of the liver. Education is directly related to the liver tested. All the characteristics of this body ...

The postoperative period is smooth. The patient quite quickly began to recover: jaundice disappeared, the liver decreased, a stretched gallbladder was not palpted: vomiting stopped; Appeet appeared. Temperature is normal all the time. After a year and a half, adding 15 kg during this time in weight, the patient began to work. As if all the reasons appeared in order to reject the suspected diagnosis of the tumor and count ...

Diagnosis of the X-ray: "diverticulous duodenum". Numerous radiographs of the stomach and duodenal gauge led another radiologist to the conviction that the picture of the duodenal change does not resemble the diverticulus, but rather corresponds to a scar suspension on the basis of ex-ulcer. The changes detected during radioscopy and the conclusions of radiologists could not satisfy the clinician who was looking for explanations for the observed in the patient ...

At the time of departure, at the station, the patient repeated abundant intestinal bleeding, about which he was again sent to the hospital. But after repeated bleeding, the judgment did not change - the patient was sent to Essentuki. It should be noted that in terms of the last conclusion of doctors it was impossible to explain the total jaundice at the beginning of suffering with the blockage of the gall stroke ...

10.IX When chronic gastritis is found chronic gastritis. During the examination of the abdomen, a small amount of free fluid was determined. Due to the fact that vomiting has become almost indomitable and the patient's condition deteriorated very quickly, re-operational intervention was proposed. Radioscopy A few days before the operation, a "duodenal tumor" was detected. The patient was operated on. When opening the abdomen, a large number of dense lymph nodes, mesenteric ...

Cancer Faterava Pacific is also known as "Cancer Bolshoi Duodenal Pacific." The diagnosis is a malignant tumor arising in the duodenum area. It may exist for a long time without showing aggression.

Packs of nipples is an anatomical structure that is localized in the middle of the duodenum, where it connects with two ducts: a common bull and main pancreatic. In most cases, the distance between it and the pyloric stomach department, the function of which consists in moving digested food into the intestines, is 10 centimeters. But sometimes this value is less than that, significantly complicates the process.

The neoplasm has an oval form and, as a rule, a small size. The average values \u200b\u200brange from 0.5 to 2.5 centimeters in diameter. Metaches the cancer of a large duodenal papilla is not often, only in 25% of cases.

Tumor classification

Classify Cancer Paterov Pacifier can be used by histological principle. In this case, these species are distinguished as:

• Adenocarcinoma;
• Petty cell type;
• Undifferentiated type;
• Solid type.

In the direction of growth, it is also customary to divide the tumor for 2 types:

• Exofic. Localizes mainly on the surface of the cover;
• Endophyte. It is capable of growing and growing deep into the tissues.

What kind of type is characteristic of a neoplary in each individual case will be able to determine the doctor on the basis of the results of diagnostic procedures.

Causes of pathology

To date, the exact causes of the development of a malignant tumor of the duodenal duodenum are not known. It is assumed that bile and pancreatic enzymes are played in this matter.

Among the possible provoking factors it is customary to allocate:

• Hereditary predisposition;
• Effect of radioactive radiation;
• Contact S. harmful substances: Toxic pairs, heavy metals, chemicals, carcinogens, etc.;
• Bad habits, such as alcohol and smoking;
• Poor nutrition implying not only the use of unhealthy and harmful food, but also the absence of a mode;
• Chronic pancreatitis;
• Adenoma;
• Family polyposis;
• Hepatobiliary diseases;
• Helmintosis.

Cancer of a large duodenal papilla is far from the most common type of tumor. IN general System All oncological diseases, it occurs in about 1-2% of cases. If we consider exclusively the gastrointestinal tract, then here on the Cancer Paterov Pacifier accounts for 5%.

The disease is almost not diagnosed in children. The risk of its development rises with age. The main peak falls on 50-55 years. Men suffer more than women.

Symptoms

For the initial stages of the tumor, the asymptomatic flow is characterized, which does not bother the patient. The first symptoms are manifested when the neoplasia grows in size and the expressed inflammatory process begins.

Initially, most patients develop jaundice mechanical character. It is expressed in the change in the color of the skin and mucous covers, as well as intense itch. Since in this period it may be the only visible sign, patients instead of cancer can suspect other pathologies, such as cholecystitis. Therefore, when jaundice appears, it is important not to engage in self-medication, but to seek advice from the doctor.

In addition, the symptoms of the Cancer Cancer Chipboard can act:

• Increased liver size, which can be determined even during palpation;
• Increased gallbladder;
• Cirrhosis of the liver;
• Reducing body weight, leading to exhaustion and even anorexia;
• Bleeding, both abundant and minor;
• Flatulence;
• Stool violation. Most often, diarrhea;
• Changing the color and smell of feces;
• Liver colic;
• Pain in the upper zone of the abdomen. It is characterized by a characteristic nature;
• Vomiting;
• Heartburn.

From the signs of general may be attended by:

• Bad state of health;
• Weakness;
• Increased body temperature;
• Nausea;
• Pallor skin;
• Dizziness.

The condition of the body is also deteriorating due to the fact that important enzymes cease in the stomach, and the function of absorption of vitamins and fats is significantly weakened.

Development Stages

Cancer of a large duodenal papilla is characteristic of the 4 main stages of the flow. These stages demonstrate the degree of prevalence of the oncological disease. They possess the following characteristics:

• The first stage. The tumor is strictly limited to the ampoule of the packer. Metastases are completely absent. Treatment gives a good result;
• Second stage. The neoplasm starts germinate to the surface of the duodenum. The depth of germination can reach 2 centimeters. Metastases are usually absent;
• Third stage. There is germination in the pancreas. Metastases occur. They apply to regional lymph nodes and closely arranged fabrics;
• Fourth stage. Any fabrics are affected, located at a distance of 2 centimeters from the hearth. Metastasation takes an extensive nature affecting remote authorities.

From what stage of the disease will the treatment be launched, its nature and forecast of a possible outcome will depend on. That is why it is important to determine it with maximum accuracy.

Diagnostic methods

Timely diagnosis of fiber-packed cancer diagnosis is complicated by the fact that the initial symptoms are very similar to the signs of many other diseases gastrointestinal tract. First of all, the patient treats the doctor's complaints, which during the inspection assesses its external state and analyzes the history.

The next step is to pass the tests:

• Urine;
• Cala;
• Blood Blood biochemical composition, including bilirubin;
• Blood to oncomarkers;
• The contents of the duodenal intestinal space.

To the instrumental methods used in this case include:

• Duodenal probing;
• Radiography;
• Fibrogastroduodenoscopy;
• Duodenal endoscopic biopsy;
• Computer and magnetic resonance tomography;
• Ultrasound procedure.

Undoubtedly, a standard biopsy remains the most informative method for determining the malignancy of the neoplasm. It lies in the seizure of the tumor sample and studying it under the microscope.

Treatment

The nature of treatment directly depends on the state of the patient and the degree of development of the tumor process. For example, in the fourth stage, only symptomatic treatment is usually carried out in order to facilitate the state of the patient. But if the disease managed to diagnose before, there is a chance for recovery.

Operative

Surgical intervention in oncology is the most effective method of treatment. Fatera nipple cancer is no exception. If there are no direct contraindications, an operation to remove a tumor is carried out.

During the procedure, there are resection of several anatomical structures at once:

• Parts of the stomach;
• Pieces of the small intestine;
• Pieces of gallway;
• Pieces of pancreatic;
• Gallbladder;
• Regional lymph nodes.

With a successful operation, 40% of patients may hope for survival for 5 years or more.

Chemotherapy

As independent treatment Chemotherapy with a big duodenal nipple cancer is ineffective. Therefore, it is more often carried out in a complex with surgical intervention. In this case, there may be 2 options:

• Before the operation - in order to reduce the size of the tumor;
• After the operation - in order to destroy the remaining cancer cells.

As a rule, such drugs are used as: fluoruracyl, mitomycin, andphosfamide.

It is important to remember that chemotherapy is usually accompanied by side effects in the form of deterioration. general status, hair loss, nausea, vomiting, headaches. It is also able to have a significant burden on the work of the kidneys.

Radiation therapy

The radiation therapy, similar to chemotherapy, is not the most effective method of treating cancer of a large duodenal papilla. It can reduce the size of the tumor about 35-45% of cases.

This type of therapy implies irradiation of oncological foci. For this, the instrument of external exposure can be used. In some cases, the radioactive substance is administered directly inside the strata of the neoplasm.

Radiation therapy is also often used in the complex with a tumor removal operation. It does not require mandatory hospitalization and is always conducted by courses. Side effects Also possible, as in the case of chemotherapy.

Prevention

Fully excluding the risk of bds cancer is impossible. But in any case, people leading healthy image Life, the risk of the disease is lower.

• Compliance with the principles of proper nutrition;
• Rejection of bad habits;
• Minimizing the effect on the body of harmful toxic substances and radioactive radiation;
• Avoiding stressful situations;
• Timely treatment of occurring diseases, especially the gastrointestinal tract.

Since 100% guarantees listed measures do not even give, it is important to periodically undergo a prophylactic inspection of the body's condition, including intestines. For those who close relatives of whom have already dealt with Cancer Fiber Pacific, it is especially important to carry out preventive recommendations.

Forecast

According to statistical data, the 5-year survival rate on average is 30-34%. A more accurate forecast of cancer depends on which cancer stage is being treated:

• On the first - more than 90%;
• On the second - 60-75%;
• On the third - 10-20%;
• On the fourth - less than 5%.

Unfortunately, the launched fourth stage of Cancer Nipple Cancer almost always leads to a fatal outcome, since during this period the tumor is inoperable.

Pateraskaya Pacific Cancer is a group of malignant tumors localized in the distal department of the total bile duct, at the place of his sign in the duodenum. Cancer Fanthersova Nipple can be primary (as a result of the development of sarcoma, carcinoid or adenocarcinoma (90% of the tumors of the packer)) and the secondary (due to the propagation of the duodenal tumor on it).

Cancer Fanthersova Pacific Point - Causes

The exact causes of the disease are not installed. In patients with family polyposis, the risk of developing the Cancer of the Nipple Cancer was elevated. The likelihood of the disease can affect the mutations of the K-RAS gene. Every year about 2 thousand new cases of carcinomas are registered in the world, make up 0.2% of all malignant gastroy tumors.

Cancer Fanta Pacific Symptoms

The main clinical manifestations of Cancer Nipples:

• mechanical jaundice (in 75% of cases)
• skin itch
• anorexia
• dyspepsia
• vomot
• reducing body weight
• dumb pain in the epigastric area (in the later stages of the disease they irradiate in the back)
• increased body temperature (with accompanying cholangitis)
• In the obstruction of the pancreatic duct, diarrhea is observed
• In the occurrence of bleeding from the tumor, blood appears in the patient chair

Cancer Fanthersova Pacific Diagnostics

Using the diagnosis of the oncological disease of the Pateraska Pacific, it is possible to differentiate from such ailments, which are known as the stricture of the biliary tract, biliary disease, cholangiocarcinoma, pancreatic cancer, chronic pancreatitis and non-Hodgkinsky lymphoma.
TO laboratory methods Diagnostics include deployed tests, including oncomarkers, bilirubin, etc. Ultrasonic examination of the abdominal cavity and biopsy will more accurately indicate the likelihood of tumor.
With the help of a spiral CT in the abdominal zone, you can more accurately explore the staging of the neoplasm. Other methods of checks can also carry out undoubted assistance in diagnosis.

Cancer Fanthersova Pacific

Treatment through surgery should proceed from an individual therapy plan, which depends on the individual flow of the disease and the health status of a particular patient.
If an oncological process is found outside the initial location to other organs, then it is necessary to assign chemotherapy or the use of rays.
As a rule, therapy begins with chemical treatmentAnd then it is necessary to conduct a control PET to determine the trend flow of the process.
If detected initial stage Nipple Faterava, then almost 80% of patients can live to five years. The definition of cancer of this type in the second and third stage is an indicator that five-year survival will be marked with approximately 17% of patients.

The absence of metastasis indicates the need for pancreatopodenal resection in accordance with the method of WIPPL operation ("Whipple"), which is a radical method. Data The type of surgical intervention may include the removal of small glands, stomach, duodenum, fiber, right half of the large seal, regional lymph nodes, etc. It can also be eliminated by the presence of a multi-fat lesion of the pancreas.
Before you decide on such an operation, you should undergo certain stages of diagnostics that will help to establish an accurate diagnosis or to develop an optimal treatment plan.

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