Pancreatic and Hepatobiliary Cancers | Clinical Medicine

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Ninja Nerds!
In this lecture, Professor Zach Murphy presents on Pancreatic and Hepatobiliary Cancers. We begin by reviewing the pathophysiology, including the most common origins and cellular involvement in pancreatic cancer, hepatocellular carcinoma, gallbladder cancer, and cholangiocarcinoma. Risk factors such as chronic pancreatitis, viral hepatitis, porcelain gallbladder, and primary sclerosing cholangitis are highlighted.

We then transition into the clinical presentation of these cancers, focusing on hallmark findings like painless jaundice, Courvoisier’s sign, ascites, and persistent right upper quadrant pain. Key complications, including cancer cachexia, hypercoagulability, exocrine pancreatic insufficiency, Budd-Chiari syndrome, and paraneoplastic polycythemia, are also discussed.

The diagnostic approach is outlined step by step, emphasizing the role of liver function tests, ultrasound, CT pancreas protocol, MRCP, ERCP with biopsy, and tumor markers such as AFP and CA 19-9. Imaging findings such as the “double duct sign” and arterial hyperenhancement with venous washout are covered in detail.

Finally, we examine treatment strategies: Whipple procedure and chemotherapy for pancreatic cancer, surgical resection and systemic therapy for hepatocellular carcinoma, cholecystectomy and chemotherapy for gallbladder cancer, and surgical resection with adjuvant therapy for cholangiocarcinoma. We also highlight when to consider transplant, radiofrequency ablation, and TACE as part of management.

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Table of Contents:
0:00 Lab
0:56 Pathophysiology and Risk Factors of Pancreatic Cancer
11:36 Classic Findings and Complications of Pancreatic Cancer
31:28 Pathophysiology and Risk Factors of Hepatocellular Carcinoma
37:21 Classic Findings and Complications of Hepatocellular Carcinoma
48:58 Pathophysiology and Risk Factors of Gallbladder Cancer
53:10 Classic Findings and Complications of Gallbladder Cancer
55:37 Pathophysiology and Risk Factors of Cholangiocarcinoma
1:01:15 Classic Findings and Complications of Cholangiocarcinoma
1:06:18 Diagnostic Approach to Pancreatic Cancer and Cholangiocarcinoma
1:12:55 Diagnostic Approach to Hepatocellular Carcinoma
1:17:58 Diagnostic Approach to Gallbladder Cancer
1:19:54 Treatment of Pancreatic Cancer
1:24:32 Treatment of Cholangiocarcinoma
1:27:10 Treatment of Hepatocellular Carcinoma
1:37:37 Treatment of Gallbladder Cancer
1:39:15 Comment, Like, SUBSCRIBE!

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