Abstract
A study was made on the significance of either ERCP or SAG and combied use of both techniques in the diagnosis of 48 cases of tumors of the pancreas. Results obtained are as follows. 1) Successful diagnosis of cancer of the pancreas by ERCP reached 93% of 42 cases studied when combined by gastroduodenal endoscopy, while that by SAG, which was applied to 40 of the 42 cases, was only 65% (26 cases). 2) As to tumors of the pancreas other than cancer, such as cyst (2 cases), insulinoma (2 cases), cystoadenocarcinoma (1 case), and metastatic cancer (1 case), there was no substantial difference in the successful diagnosis between ERCP and SAG. 3) Next, diagnosability of cancer of the pancreas was compared between ERCP, SAG and combination of both techniques. a) Diagnosability of the presence or absence of cancer The diagnosability of the presence or absence of cancer was higher by ERCP than by SAG, when the cancer is in the central part of the pancreas along the main duct, whereas it was higher by SAG than by ERCP, when the cancer is in the peripheral area or in the viscinity of the margin of the pancreas. Accordingly, it was indicated that the diagnosabilility of the entire pancreas was much higher when ERCP and SAG were combined. b) Diagnosability of the nature of cancer : ERCP was found to provide much more important informations on not only changes of gastroduodenal, pancreatic and biliary tracts, but also on anastomosis at the time of surgical operation, while it did not contribute to the diagnosis of the tumor size, way of infiltration of cancer cells and/or presence or absence of metastasis. In contrast, SAG provided much more inf ormations on the latter or on resectability of cancer. From these results, it was concluded that the combined application of ERCP and SAG was essential for the exact diagnosis of tumors of the pancreas.
