Diagnostic Ability and Limitation of ERCP for Pancreatic Cancer K. Takagi 1 , T. Takekoshi 2 , K. Oohashi 2 1Department of Surgery, Cancer Institute Hospital 2Department of Internal Medicine, Cancer Institute Hospital pp.1065-1080
Published Date 1982/10/25
DOI https://doi.org/10.11477/mf.1403108750
  • Abstract
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 ERCP has been clinically introduced for more than 10 years, we evaluated its diagnostic ability and limitation for pancreatic cancer. ERP was found to have significant impact for diagnosing pancreatic cancer and we proposed a classification of ERP findings of pancreatic cancer by analyzing its location and morphological change of the main pancreatic duct. Furthermore we showed the classification was quite useful for diagnostic imaging modalities such as US and CT.

 Although advanced pancreatic cancer became easily diagnosed by ERP, angiography, US and CT, small intrapancreatic lesions are somewhat difficult to be diagnosed.

 Analyzing three cases of small intrapancreatic loca-lized cancer which were less than 2 cm in diameter, we found that a diagnostic ability of ERCP for small intrapancreatic lesions was excellent if it affect the main pancreatic duct to be visualized by ERP as stenotic or obstructive lesions. However, there was a risk to miss lesions of the uncinate process where there is no change of main pancreatic duct and it was a limitation of ERP.

 Furthermore, we analyzed five cases of localized benign lesions in which pancreatic cancer was suspected, and we found they were due to localized pancreatitis, ductal hyperplasia or atypical hyperplasia of the pancreatic duct. The intrapancreatic lesions, which showed stenosis of the main pancreatic duct, should be operated on and histological investigation should be carried out, even if it is quite difficult to differentiate benign from malignant one.

 Among the pancreatic cancer, mucous-producing carcinoma, which is classified as type III by ERCP classification because of specific findings at the papilla of Vater, could be diagnosed by morphological change of the main pancreatic duct by ERP,US and CT. If we pay more attention to the characteristic findings of the specific type of pancreatic cancer, their discovery rate will be increased.

Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院


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