Liver, Pancreas and Biliary (HPB)
Definition/Description
These forms are only to be used for referrals with a high risk of cancer. To assist you in evaluating the potential risk for cancer the QCancer assessment can be beneficial. QCancer has been developed for the UK with risk algorithms. This tool will only provide a level of risk of cancer and is not a diagnosis tool.
Red Flag Symptoms
- Weight loss / painless jaundice
- Abdominal Mass
- Pancreatic Insufficiency – steatorrhea
- Radiological suspicion of malignancy
- New onset Diabetes
- Change in diabetic requirements if already a diabetic
- Back pain
Exclude Red Flag Symptoms
Refer to Acute Surgery HRI any patients with the following symptoms
- Bilirubin >200
- Evidence of renal compromise
- Clotty abnormalities/GI Bleed
- Suspected Cholangitis
DO NOT REFER
Anaemia (Fe deficient))
Deranged liver enzymes without jaundice (if patient on statins and no radiological evidence of biliary disease) refer to gastroenterology)
Guidelines on Management
Jaundice <40
• Urgent Ultrasound or referral to HPB clinic
Jaundice >40
• Urgent CT and/or referral to HPB clinic
Referral Criteria/Information
Aged 40 and over and have jaundice
Consider an urgent direct access CT scan (to be performed within 2 weeks) for pancreatic cancer in people aged ≥60 yrs and over with weight loss and any of the
following: (Should be FIT test negative to refer on this pathway or use Colorectal 2 WW)
• Diarrhoea
• Back pain
• Abdominal pain
• Nausea
• Vomiting
• Constipation
• New Onset Diabetes
Please complete all referral forms sections and Fax to: 01482 675505
The Central Referral Point telephone number is: 01482 604308
Electronic referrals can be made via the NHS e-Referral system. Services for a 2 week wait, suspected cancer are found by searching on speciality for 2ww and then selecting the clinic type i.e. 2ww Upper GI.
Additional Resources & Reference
Information to include
Medical History / Drugs / Allergies
• Recent FBC, U&E, LFT (less than 8 weeks old)
• Is the patient fully active
• Able to carry out light work
• Up & about 50% of waking time
• Limited to self-care, confined to bed/chair 50%
• No self-care, confined to bed/chair 100%
• Weight Loss Amount : Duration:
Associated Policies
Specialties
Places covered by
- east-riding
- hull
- north-east-lincolnshire
- north-lincolnshire
Hospital Trusts
- hull-university-teaching-hospitals