<prompt> Pancreatic carcinoma most common variety is:AdenocarcinomaNeuroendocrine tumourMucous secreting tumourAcinar cell cystadenocarcinoma  <response>: Ans: a Adenocarcinoma Ref: Bailey Love, 24th ed, p. 1128More than 85 of pancreatic carcinoma are duct cell adenocarcinoma.Prolonged natural history - CystadenocarcinomaIncreased survival after resection - Ampullary tumour, neuroendocrine tumourStart as a benign tumour and progress after years into an aggressive malignant lesionMen and women have equal occurrence.- Intraductal, papillary mucous secreting tumour.Neoplasms of pancreas are of two types1. Those arising from endocrine pancreas i.e., islet cells2. Those arising from exocrine pancreas i.e., ducts and aciniFunctional pancreatic endocrine tumours Insulinoma - From 6 cells produce insulin symptoms of hypoglycemia Gastrinoma - From G cells produce gastrin Zollinger Ellison syndrome Glucagonoma - Arise from a cells produce glycogen hyperglycaemia Somatostatinoma - Arise trom a or D cells VIPoma GRFomas many othersBRIDGEPassaros triangle - about 70-90 of gastrinoma are located within this triangle 3 points making the Passaros triangle:- Junction of cystic duct and CBD- Junction of 2nd and 3rd portion of duodenum- Junction of neck and body of pancreasWhipple triad Insulinoma Signs symptoms of hypoglycaemia during fasting Relief of symptoms by intravenous administration of glucose Blood glucose below 2.8 mmol1 50 mgdl during symptomatic episodesTreatment of Ca head of pancreasWhipple resection 