Abstract
My experience with digestive endoscopy started in 1957 when I became a member of Hokkaido Univercity's Third Department of internal Medicine and received instruction in gastra-camera technique under Lecturer Masayoshi Namiki wha is naw Han-orary Professor at Asahikawa Medical College.After that I proceeded to do research on the Iarge intestine as well as the biliary tract and pancreas. I fell greatly indebted to the instruction of Dr Hikoo Shirakabe, the late Ryozo Sano and the late Satoru Soma, and Rikiya Fujita who is presently Professor of Digestive Medicine at Showa University's Fuligaoka Hospital. In the begining, ERCP contributed greatly to. the development of the diagnosis of pancreatic disease. 1Vext came diagnostic imaging such as US, EUS, CT and MRS which ail contributed to the improvement of diagnostic efficacy, However the diagnosis of early pancreatic cancer still remained elusive. Since 1988 we have been re:porting that the use of peroral micro-pancreatoscopy(PMPS) using an ultrathin fiberscape with an external diameter of 0.75mm has been very effective in the differential diagno-sis of pancreatic disease. Recently understanding of the relationship between lesions of the pancreas and surrounding blood vessels has become possible through endoscopic color-doppler ultra-sanagraghy (ECDUS). Intraductal ultrasonography(IDUS)(Civis; probe diameter:1.4mm, at 30MHz) has made it possible for the detailed observation of the area around the main pancreatic duct. Diagnostic efficacy of pancreatic disease has improved and we have had fi cases of pancreatic cancer with 5-year survival. Four of these were t1 eases. In order to make early diagnosis of pancreatic cancer, after screening tests and observation of symptoms, EUS and ERCP should be applied. If there are abnormal findings in the pancreatic tract we shouid give precise ERP, and if appropriate, PMT'S and IDUS. In order to obtain a definite diagnosis, pancreatic biopsy and cytology should be applied.
