This document provides an overview of a presentation on the fundamentals and generalities of medical management of pancreatic disorders. The presentation covers topics such as the anatomy and functions of the pancreas, definitions of pancreatic disorders and diseases, common types of pancreatic disorders, causes, diagnosis, and basic treatment modalities. It emphasizes that pancreatic disorders are commonly diagnosed late due to the organ's deep location and vague early symptoms. The document also provides statistics on pancreatic cancer in the Philippines.

1. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
PANCREATIC
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of PANCREATIC
DISORDERS
[OVERVIEW]
May 21, 2022
1400H - 1500H
Via Zoom

2. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
PANCREATIC
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of PANCREATIC
DISORDERS
[OVERVIEW]
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

3. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

4. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.

5. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
PANCREATIC
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of PANCREATIC
DISORDERS
[OVERVIEW]
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of
PANCREATIC
DISORDERS [AN
OVERVIEW]. This is
part of the Health
Disorder Course.

6. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
Contents of PEP TALK on PANCREATIC DISORDERS
• What is the pancreas?
• What is a pancreatic disorder?
• What are the different types of pancreatic
disorder?
• What are the causes of pancreatic disorder?
• How common is pancreatic disorder?
• Clinical diagnosis of pancreatic disorder
• Paraclinical diagnostic procedures for
pancreatic disorder
• Basic treatment modalities for pancreatic
disorder
• Overview on PANCREATIC CANCER

7. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?

8. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?
The pancreas is an organ located deep in the
upper part of the abdomen or belly (behind
stomach).

9. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?
The pancreas can be divided into Head, Neck,
Body and Tail.

10. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?
The pancreas is an organ of the digestive
system and endocrine system.
As part of the digestive system, it plays an
essential role in converting the foods we eat into
fuels for the body's cells.
As part of the endocrine system, it plays an
essential role in regulating blood sugar.

11. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?
It has two main functions:
an exocrine function (99%) that helps in digestion
and
an endocrine function (1%) that regulates blood
sugar.

12. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is the pancreas?
One can live without a pancreas.
However, one will need to make a few
adjustments though.
The pancreas makes substances that control
blood sugar and help the body digest foods.
After surgery with total removal, one will have to
take medicines to handle these functions.

13. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is a pancreatic disorder?

14. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is a pancreatic disorder?
First, the meaning of DISORDER.
DISORDER is a definite disruption to regular
bodily structure and function but the specific
cause is not yet determined.
Once identified, the specific cause is called
the DISEASE.

15. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What is a pancreatic disorder?
A PANCREATIC DISORDER is a DISORDER OF THE
PANCREAS.
- definite disruption to regular bodily structure
and function of the pancreas
- but the specific cause is NOT yet determined.

16. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the different types of pancreatic
disorder?

17. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the different types of pancreatic
disorder?
Generally, 3 types:
• Pancreatic tumors (cancerous / non-
cancerous)
• Pancreatic inflammation / infection
(pancreatitis)
• Pancreatic endocrine disorder (diabetes
mellitus)

18. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the causes of pancreatic disorder?

19. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the causes of pancreatic disorder?
Pancreatic Tumors
• Pancreatic newgrowth tumors (cancerous /
non-cancerous)
• Gene mutations (exact mechanisms not yet
known)
• Grave concern – pancreatic cancers
(adenocarcinomas)
• Pancreatic non-newgrowth tumors (e.g. cystic
degeneration)

20. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the causes of pancreatic disorder?
• Pancreatic inflammation / infection
(pancreatitis)
• Common causes:
• gallbladder stones in the common bile
duct obstructing the pancreatic duct
• alcohol intake

21. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• What are the causes of pancreatic disorder?
• Pancreatic endocrine disorder
• Most common disease – diabetes mellitus

22. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• How common is pancreatic disorder?

23. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• How common is pancreatic disorder?
• Common - not rare
• Pancreatic inflammation / infection
(pancreatitis) – more common than pancreatic
tumors
• Pancreatic endocrine disorder (diabetes
mellitus) – most common

24. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder

25. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder
Focus:
• Acute pancreatitis
• Pancreatic tumors

26. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder
Acute pancreatitis
• Pattern Recognition Cues:
• pain in the upper abdomen that
radiates to the back.
• abdominal pain worsens after eating,
especially foods high in fat.
• abdomen is tender to touch.
• May or may not have fever.

27. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder

28. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder
Pancreatic tumors and cancers
Because of its deep location, most tumors of the
pancreas cannot be felt when pressing on the
abdomen.
This leads to late detection, as symptoms of
pancreatic cancer usually do not appear until the
tumor begins to interfere with the function of the
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
Pancreatic tumors
and cancers are
usually not
diagnosed clinically
but with imaging
procedures like
ultrasound and CT
scan and MRI.

29. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder
Pancreatic cancers
Because of its deep location, most tumors of the
pancreas cannot be felt when pressing on the
abdomen.
This leads to late detection, as symptoms of
pancreatic cancer usually do not appear until the
tumor begins to interfere with the function of the
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
Patients with
pancreatic tumors
can be
asymptomatic and
symptomatic.
If symptomatic, they
usually starts with
vague abdominal
pain at the
epigastric area.

30. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder Patients with
pancreatic HEAD
tumors usually
present with
JAUNDICE because
of the common bile
duct obstruction
they cause.

31. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Clinical diagnosis of pancreatic disorder Patients with
pancreatic HEAD
tumors can cause
gastric outlet
obstruction if they
grow into the
duodenum or small
intestine.

32. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Paraclinical diagnostic procedures for
pancreatic disorder

33. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Paraclinical diagnostic procedures for
pancreatic disorder
Common instrumental and laboratory diagnostic
procedures for PANCREATIC DISORDER:
• Imaging procedures (ultrasound; CT scan; MRI;
PET scan; etc.)
• Endoscopy (upper endoscopy) – ERCP, EUS
• Blood tests (pancreatic enzymes, tumor
markers; etc.)
• Biopsy
ERCP – Endoscopic
Retrograde
Cholangio-
Pancreaticography
EUS – Endoscopic
ultrasound

34. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Paraclinical diagnostic procedures for
pancreatic disorder
Competencies required of physicians managing
pancreatic disorders:
• Know the uses and indications of all known
instrumental and laboratory diagnostic
procedures for pancreatic disorders.
• Use as needed and indicated.
• Select the most cost-effective one using the
BRCA process.
• Know how to interpret the results.

35. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Paraclinical diagnostic procedures for
pancreatic disorder
Procedures Benefit
(goal – to
be more
definite on
the
diagnosis)
Risk Cost Availability
Option1
Option2
Option3
BRCA Process in selecting diagnostic procedures

36. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Paraclinical diagnostic procedures for
pancreatic disorder
Usually, an ultrasound is initially done for patients
suspected to have a pancreatic disorder.
After the ultrasound, other paraclinical diagnostic
procedures may be done as indicated such as
pancreatic enzyme determinations like serum
amylase and lipase.

37. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder

38. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
SPECIFIC DISEASE SURGICAL / POTENTIALLY SURGICAL / NON-SURGICAL
W
X
Y
Z
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed

39. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
Examples of OUTRIGHT SURGICAL TREATMENT
• Resectable pancreatic cancers
• Necrotizing pancreatitis (with severe
inflammation)
Surgical Treatment:
• Remove or
extirpate
• By-pass or detour
procedure
• Debridement
• Drainage

40. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
Illustration of extirpation of pancreatic head cancer - pancreaticoduodenectomy

41. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
Surgical Treatment:
• Remove or
extirpate
• By-pass or detour
procedure
• Debridement
• Drainage
Examples of POTENTIALLY SURGICAL TREATMENT
in which a WATCH & WAIT stance is a better
option and in which a medical management can
be tried
• Acute pancreatitis
• Pancreatic abscess (small)
• Pancreatic pseudocyst
• Benign pancreatic tumors

42. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
Examples of OUTRIGHT NON-SURGICAL
TREATMENT
• Mild acute pancreatitis
• Chronic pancreatitis
• Unresectable pancreatic cancer – just palliative
treatment
Non-Surgical
Treatment:
• Medicines
• NO medicines
(watchful waiting;
natural support
management;
etc.)

43. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Basic treatment modalities for pancreatic
disorder
BRCA Process in selecting cost-effective treatment
modality.

44. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers

45. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers
Pancreatic cancer statistics in the Philippines
(Globocan 2020)
No. 14 in incidence rank
No. 8 in mortality or death rank
Prevalence: 3 / 100,000 population

46. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers
USUALLY LATE DETECTION
Because of its deep location, most tumors of the
pancreas cannot be felt when pressing on the
abdomen.
This leads to late detection, as symptoms of
pancreatic cancer usually do not appear until the
tumor begins to interfere with the function of the
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
Late detection
Advanced stage of
cancer
Poor prognosis

47. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers

48. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers

49. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancers

50. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer

51. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
USUALLY LATE DETECTION
Early symptoms are usually non-specific, a vague
and dull upper abdominal pain at the epigastric
are o sikmura.
Usually, loss of appetite and weight follow.

52. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
Causes NOT exactly known.
About 10% of pancreatic cancers are hereditary.
The rest are acquired – due to gene mutation –
with no known exact cause.
Anybody can be afflicted with pancreatic cancer,
when and how, nobody exactly knows.

53. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
2 general types of pancreatic cancers:
• Adenocarcinoma (more common)
• Neuroendocrine Tumors

54. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
In general, pancreatic neuroendocrine tumors
grow at a much, much slower rate than pancreatic
adenocarcinomas.
While each type of tumor can spread
(metastasize) from the pancreas to other organs,
pancreatic neuroendocrine tumors usually spread
over a period of years.

55. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
Screening for Pancreatic Cancers
For pancreatic cancer, no major professional
groups currently recommend routine screening in
people who are at average risk.
This is because no screening test has been shown
to lower the risk of dying from this cancer.

56. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
Screening for Pancreatic Cancers
There is no single diagnostic test that can tell you
if you have pancreatic cancer.
Definitive diagnosis requires a series of imaging
scans, blood tests and biopsy—and those tests are
typically only done only if you have symptoms.

57. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
Paraclinical diagnostic procedures
• Ultrasound of the abdomen
• CT scan
• MRI
• CA-19-9
• Biopsy

58. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
• Overview on Pancreatic Cancer
Treatment
Early stage, resectable, with no evidence of
distant spread - SURGERY is the treatment of
choice.
Otherwise – chemotherapy or no more
conventional medical treatment (palliative and
Hospice care)

59. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
Summary
Take Away
Contents of PEP TALK on PANCREATIC DISORDERS
• What is the pancreas?
• What is a pancreatic disorder?
• What are the different types of pancreatic
disorder?
• What are the causes of pancreatic disorder?
• How common is pancreatic disorder?
• Clinical diagnosis of pancreatic disorder
• Paraclinical diagnostic procedures for
pancreatic disorder
• Basic treatment modalities for pancreatic
disorder
• Overview on PANCREATIC CANCER

60. Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
Be always in touch with reliable medical
information on fundamentals and
generalities in medical management of
PANCREATIC DISORDERS.
Take Away in
relation to
Patient
Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of PANCREATIC
DISORDERS.

61. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
PANCREATIC
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of PANCREATIC
DISORDERS
[OVERVIEW]
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of
PANCREATIC
DISORDERS [AN
OVERVIEW]. This is
part of the Health
Disorder Course.