Abstract
During the period from February 1965 to April 1981, we experienced 7 patients with carcinoma of the pancreas smaller than 3 cm in maximum diameter, defined as small pan-creatic cancer. All of the 7 cases presented with jaundice and their tumors were located in the pan-creatic head. Pancreatogram was obtained in six cases, in which the findings were a marked stenosis with poorly visualized branches in four cases and an obstruction of the main pancreatic duct in two cases. These findings were essentially identical to those seen in advanced pan-creatic cancers, but the involvement was confined to a short segment of the main pancre-atic duct. All of the patients were operated on (pancreatoduodenectomy in 5 cases and total pancreatectomy in 2 cases) and were found to have either lymph node metastasis, duodenal or retroperitoneal invasion microscopically. The diagnosis of pancreatic cancers by ERCP is not so difficult in almost all cases even in patients with a small pancreatic cancer. In cases in which the diagnosis is indeter-minate despite other diagnostic modalities are utilized, laparotomy should be performed to detect small and curable pancreatic cancers. Apart from this approach, it is most important to establish the screening methods for pancreatic cancer which may increase the frequency of these lesions.
