Abstract
The clinical, biochemical and radiological findings in 16 patients with carcinoma of the head of the pancreas were compared with that of 13 with cholestatic jaundice due to chronic pancreatitis. Patients presenting with malignancy had more severe hyperbilirubinemia (18.5 +/- 2.1 vs 5.6 +/- 1.6 p to ten days of hospital admission was the single most accurate test distinguishing carcinoma from pancreatitis. The mean bilirubin rose in carcinoma but fell in pancreatitis (mean net change 15.1 +/- 2.9 vs 3.9 +/- 0.6, p less than 0.001). Calcification in the pancreatic region was identified on a flat plate of the abdomen in 8/13 with pancreatitis but 0/16 with malignancy. Preoperative percutaneous transhepatic cholangiography was helpful in defining the site of biliary obstruction but the radiologist was unable to clearly predict the definitive diagnosis in five of the 29 patients. A point score based upon the major significant differences noted, predicted the presence or absence of malignancy in all patients (16/16 vs 0/13, p less than 0.01).
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- DiMagno E. P., Malagelada J. R., Taylor W. F., Go V. L. A prospective comparison of current diagnostic tests for pancreatic cancer. N Engl J Med. 1977 Oct 6;297(14):737–742. doi: 10.1056/NEJM197710062971401. [DOI] [PubMed] [Google Scholar]
- Gilsdorf R. B., Spanos P. Factors influencing morbidity and mortality in pancreaticoduodenectomy. Ann Surg. 1973 Mar;177(3):332–337. doi: 10.1097/00000658-197303000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldstein H. M., Neiman H. L., Bookstein J. J. Angiographic evaluation of pancreatic disease. A further appraisal. Radiology. 1974 Aug;112(2):275–282. doi: 10.1148/112.2.275. [DOI] [PubMed] [Google Scholar]
- Nakase A., Matsumoto Y., Uchida K., Honjo I. Surgical treatment of cancer of the pancreas and the periampullary region: cumulative results in 57 institutions in Japan. Ann Surg. 1977 Jan;185(1):52–57. doi: 10.1097/00000658-197701000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Purow E., Hadas N., Grosberg S. J., Wapnick S., Suster B., LeVeen H. Percutaneous transhepatic cholangiography: an experience with the Chiba needle. Am Surg. 1979 Jul;45(7):431–438. [PubMed] [Google Scholar]
- RANKIN G. B., BROWN C. H. CLINICAL EVALUATION OF THE RESULTS OF THE SECRETIN TEST AND OF DUODENAL CYTOLOGY IN THE DIAGNOSIS OF PANCREATIC DISEASE. Cleve Clin Q. 1964 Apr;31:119–126. doi: 10.3949/ccjm.31.2.119. [DOI] [PubMed] [Google Scholar]
- Reuben A. Operative pancreatic biopsy: a survey of current practice. Ann R Coll Surg Engl. 1978 Jan;60(1):53–57. [PMC free article] [PubMed] [Google Scholar]
- Tylén U., Arnesjö B., Lindberg L. G., Lunderquist A., Akerman M. Percutaneous biopsy of carcinoma of the pancreas guided by angiography. Surg Gynecol Obstet. 1976 May;142(5):737–739. [PubMed] [Google Scholar]