[Problems of early diagnosis of pancreatic cancer and evaluation of various morphological studies]

Clinical symptoms and abnormality of laboratory examinations in 62 patients with proven pancreatic carcinoma were studied. The following indications for detailed examination of the pancreas have been evolved: (1) vague abdominal symptoms, (2) jaundice, (3) abnormalities of laporatory examinations including serum LAP, ALP, amylase and cholinesterase level, and abnormal GTT. In the jaundiced patient the initial examination is US followed by PTCD to relieve the jaundice, and then angiography to assess resectability of the tumor. In the non-jaundiced patient US is used as a screening procedure. Should this be abnormal a lesion may be confirmed by CT. If not ERCP is indicated when there is some distinct reason to suspect pancreatic disease. If ERCP reveals abnormality then angiography is performed to determine whether the lesion is benign or malignant, and if malignant it is resectable or not. In the period of 1968 and 1981, 112 proven pancreatic carcinomas were studied. Overall resectability was 26%. Thirty tumors were less than 3 cm and the smallest lesion measured 1.2 cm.