Changes

==Treatment==

==Treatment==

===Surgery===

===Surgery===

Often at the time of diagnosis adenocarcinomas have already metastasised or local invasion has already taken place. If metastasis has no yet occurred surgical resection may be attempted with care to avoid iatrogenic trauma to the vascular supply to the proximal duodenum and obstruction of the main pancreatic duct. Total pancreatectomy and pancreaticoduodenectomy (Whipple's procedure) are not advised. Tumours of the body or base of the pancreas are inoperable. Gastrojejunostomy (gastrointestinal bypass) may be performed for short erm palliation. Small pancreatic adenomas may be removed via partial pancreatectomy.

Usually at the time of diagnosis adenocarcinomas have already metastasised or local invasion has already taken place. If metastasis has no yet occurred surgical resection may be attempted with care to avoid iatrogenic trauma to the vascular supply to the proximal duodenum and obstruction of the main pancreatic duct. Total pancreatectomy and pancreaticoduodenectomy (Whipple's procedure) are not advised. Tumours of the body or base of the pancreas are inoperable. Gastrojejunostomy (gastrointestinal bypass) may be performed for short term palliation. Small pancreatic adenomas may be removed via partial pancreatectomy.

===Chemotherapy===

===Chemotherapy===