8. Pancreatic and Biliary Cancer

  1. Janusz Jankowski MB ChB, MSc, MD, PhD, FRCP, FACG, AGAF2,3,4 and
  2. Ernest Hawk MD, MPH5
  1. Neil Bhardwaj and
  2. David M. Lloyd

Published Online: 15 NOV 2012

DOI: 10.1002/9781118423318.ch8

Handbook of Gastrointestinal Cancer

Handbook of Gastrointestinal Cancer

How to Cite

Bhardwaj, N. and Lloyd, D. M. (2012) Pancreatic and Biliary Cancer, in Handbook of Gastrointestinal Cancer (eds J. Jankowski and E. Hawk), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118423318.ch8

Editor Information

  1. 2

    Sir James Black Professor of Gastrointestinal Biology and Trials, Centre for Digestive Diseases, Barts and Th e London School of Medicine and Dentistry, London, UK

  2. 3

    Consultant Gastroenterologist, University Hospitals of Leicester, Leicester, UK

  3. 4

    James Black Senior Fellow, University of Oxford, Oxford, UK

  4. 5

    Vice President and Division Head, Division of Cancer Prevention & Population Sciences, Boone Pickens Distinguished Chair for Early Prevention of Cancer, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Author Information

  1. University Hospitals of Leicester, Leicester, UK

Publication History

  1. Published Online: 15 NOV 2012
  2. Published Print: 12 JUL 2012

ISBN Information

Print ISBN: 9780470656242

Online ISBN: 9781118423318



  • Pancreatic cancer;
  • biliary cancer;
  • gallbladder cancer;
  • whipples procedure;
  • hilar cholangiocarcinoma


Pancreatic and biliary cancers have a dismal prognosis due to the majority of cancers presenting with innocuous and nonspecific symptoms till they are at an advanced stage. In the small minority of patients deemed potentially resectable, a thorough and comprehensive preoperative assessment of patient fitness and tumor extent is essential in order to avoid the patient undergoing an unnecessary laparotomy. This includes discussion in MDT meeting, anesthetic assessment, and a laparoscopy. Patients deemed unfit or inoperable undergo drainage of their jaundice and referred to the oncologist. Adjuvant chemotherapy postoperatively and primary chemotherapy for inoperable disease have improved survival significantly.