About the differential diagnosis of pancreatic cancer and periampullary carcinoma

Regarding the differential diagnosis of pancreatic cancer and periampullary carcinoma, pancreatic cancer is a highly malignant digestive tract tumor that is difficult to diagnose and treat. It is a ductal adenocarcinoma of which about 90% originate from the glandular duct epithelium. Due to its extremely low survival rate, pancreatic cancer is listed as the "stubborn fortress of the 21st century" by the surgical community internationally. To prevent pancreatic cancer, it is very important to distinguish diseases that are confused with it. And periampullary carcinoma is undoubtedly the disease that is most likely to be "inseparable" from pancreatic cancer.

It is undeniable that periampullary cancer and pancreatic cancer are very similar, but they are two different diseases after all, and we can still follow the clues to distinguish them. On the one hand, in addition to abdominal pain and jaundice, pancreatic cancer patients also have loss of appetite and obvious weight loss, while the loss of appetite and weight loss of periampullary cancer patients are relatively mild; on the other hand, obstructive jaundice of pancreatic head cancer appears late, progressively worsens, and rarely fluctuates, while jaundice of periampullary cancer appears earlier, may fluctuate, and is accompanied by positive stool occult blood.
More importantly, ultrasound and CT scans of pancreatic cancer show a deformed, enlarged, and irregular pancreas, with dilatation of the pancreatic duct and common bile duct, whereas ultrasound and CT scans of periampullary cancer show no abnormalities in the pancreas, with dilatation of the intrahepatic and extrahepatic bile ducts.