Updates in the diagnosis and management of ductal adenocarcinoma of the pancreas

Figure 1 Pancreatic ductal adenocarcinoma. A: Scheme of diagnostic approach for pancreatic ductal adenocarcinoma (PDAC) in order of priority; B: Scheme of criteria for local borderline resectable PDAC; C: Scheme of PDAC management. Tu: Tumor; SMV: Superior mesenteric vein; SMA: Superior mesenteric artery; PV: Portal vein; CA: Celiac axis; CHA: Common hepatic artery; PHA: Proper hepatic artery; PPD: Proximal pancreatoduodenectomy; DP: Distal pancreatectomy, TP: Total pancreatectomy; LND: Lymph node dissection; FOLFIRINOX: Leucovorin, 5-fluorouracil, irinotecan, oxaliplatin; GEMNABP: Gemcitabine + nab-paclitaxel; NALIRIFOX liposomal irinotecan, fluorouracil, leucovorin, oxaliplatin + certepetide (for chemoresistance); PDAC: Pancreatic ductal adenocarcinoma; MDCT: Multidetector computed tomography; CT: Computed tomography; MRI: Magnetic resonance imaging; MRCP: Magnetic resonance cholangiopancreatography; EUS: Endoscopic ultrasound; FNA: Fine needle aspiration; FNB: Fine-needle tissue biopsy; PET: Positron emission tomography; CA 19-9: Carbohydrate antigen.