Pancreatic Head Cancer: Epidemiological, Clinical, Diagnostic, Therapeutic and Evolutionary Aspects

Pancreatic head cancer is one of the leading causes of death in adults worldwide. It has now become a public health problem in developing countries because of its poor prognosis. The aim of this work was to describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects. This was a retrospective and descriptive study carried out over a period of 3 years and 6 months from 1 January 2015 to 30 June 2018 in the Department of Gastroenterology and Internal Medicine of the University Hospital Center of Brazzaville. Subjects of both sexes, over the age of 18, with complete medical records were included in our study. Of 4229 patients admitted, 55 were included, ie a hospital frequency of 1.3%. Men accounted for 55.5% and women accounted for 45.5% with a sex ratio of 1.75. The mean age was 62.4 ± 12.3 years with extremes ranging from 40 to 95. The associated risk factors were alcohol 54.5% of cases (n = 30) followed by tobacco in 30, 9 cases (n = 17). The average consultation time was 2.7 ± 3 months. The most common reason for consultation was jaundice in 96.4% of cases (n = 53). The majority of patients had a high status of WHO at 4 in 58.2% of cases. The majority of patients had hepatomegaly in 70.9% (n = 39) followed by a large gallbladder in 38.4% (n = 21). Biological cholestasis was present in 92% of cases (n = 51). Abdominal ultrasound showed hypertrophy of the pancreas head in 100% of cases (n = 55). The abdominal CT scan revealed hypodense hypertrophy in 81.8% of cases (n = 45). The majority of our patients were undergoing palliative treatment and the case fatality rate was 98.2% (n = 54) at 24 months. The frequency of cancer of the pancreatic head was relatively low. The diagnosis is often late, making it difficult to take charge, which is responsible for the poor prognosis.