Hepatobiliary System of Pancreas

Pancreatic cancer is currently the fourth most common cause of cancer-related deaths in the United States. Approximately 32,000 Americans are diagnosed each year with pancreatic cancer, and the same number die each year. About 23% of patients survive 1 year after diagnosis, and fewer than 5% of persons with the disease are alive 5 years after diagnosis.

Tumors can develop in both the exocrine and the endocrine tissue of the pancreas, although 95% arise from the exocrine parenchyma (functional tissue) and are referred to as adenocarci-nomas. The remaining 5% of pancreatic tumors develop from endocrine cells of the pancreas; they are named according to the hormone they produce (i.e., insulinomas, glucagonomas). Adenocarcinoma of the ductal origin is the most common exocrine cell type (75% to 92%), and it occurs most frequently in the head of the pancreas. Pancreatic adenocarcinoma grows rapidly, spreading to the stomach, duodenum, gallbladder, liver, and intestine by direct extension and invasion of lymphatic and vascular systems. Further metastatic spread to the lung, peritoneum, and spleen can occur. Metastatic tumors from cancers in the lung, breast, thyroid, or kidney or skin melanoma have been found in the pancreas.

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