醫療事故　港大深圳醫院求醫證患癌　婦人切除胰臟後亡驚揭無腫瘤　家屬追究醫生刑事責任

辱華…抵死。

咁老實講，一個subspecialised 嘅surgeon 睇佢做開個site係可以叻過普通radiologist 嘅，especially 佢可以correlate clinically 。

正想講
咁大隻字寫
D PANCREAS, SPLEEN, DUODENUM and distal STOMACH, excision: — PANCREAS: Intraductal Papillary Mucinous Neoplasm with intermediate dysplasia.

開一兩年醫委會

啲醫生開始唔掂到要作埋呢啲故仔俾報紙佬出鱔稿？

The treatment modalities of IPMN were described in the Fukuoka guidelines: patients with main or mixed duct IPMN should be always scheduled for surgical resection. Branch duct lesions with „worrisome features“(cystic size > 30 mm, thickened cystic walls, non-enhanced mural lesions, dilatation of the pancreatic duct of 5 – 9 mm, lymphadenopathy, distal pancreatic atrophy, caliber alterations of the pancreatic duct) or “high-risk stigmata” (duct dilatation > 5 mm, solid enhancing components with biliary obstruction) should be considered for surgical resection. Clinically symptomatic lesions always require surgical intervention.

真係會切架喎

IPMN, head of pancreas有嘢, 做Whipple好合理
問題喺點解變咗total pancreatectomy姐

講真......
邊有一個modality 真係有100% specificity。

尤其是了完ERCP，都唔知會唔會pancreatitis，之後啲FDG uptake 高咗。

Some people might not need a biopsy
For patients with resectable disease based on imaging tests, the surgeon could proceed directly with surgery, at which time the tumor cells can be looked at in the lab to confirm the diagnosis. During surgery, if the doctor finds that the cancer has spread too far to be removed completely, only a sample of the cancer may be removed to confirm the diagnosis, and the rest of the planned operation will be stopped.

If treatment (such as chemotherapy or radiation) is planned before surgery, a biopsy is needed first to be sure of the diagnosis.

source: american cancer society

之前好似有個醫生巴打講過話pancreas 唔一定做手術前抽組織。因為唔係個個位都咁accessible?

呢條咖哩狗龜縮晒扮睇唔到啦

活摘器官

唔做biopsy 就直接切?

真係唔怪之得咁多醫療事故
冇心醫人好心返屋企量地

Indication for surgery: ?IPMN
final histology: IPMN

Case closed.