Surgical techniques of cytology-guided pancreatectomy for occult neoplasm of the pancreas.
OBJECTIVE
In recent years, we have succeeded in treating an occult cancer of the pancreas by making the most of cytodiagnosis for the pure pancreatic juice.


METHODS
Even for the patients in whom obvious tumor was not depicted by imaging techniques, the pure pancreatic juice was collected during endoscopic retrograde pancreatography and it was cytologically examined.


RESULTS
When cancer cell was detected, both the location of occult lesion and the range of pancreatectomy were determined by the intraoperative cytology for the pancreatic juice which was collected separately from the cranial and caudal segments (2-segmental cytology). More recently, using a balloon catheter, the pancreatic juice of the head, body and tail, (3-segmental cytology) was examined. The former method was effective to prevent the blind resection of the entire pancreas, and the latter provided us with the opportunities to preserve much more pancreatic function.


CONCLUSIONS
This method was a useful aid in resecting potentially curable cancer of the pancreas. The present paper introduces the detailed techniques of this method.
Ishikawa
O
O
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Ohigashi
H
H
Imaoka
S
S
Takenaka
A
A
Uehara
H
H
Nakaizumi
A
A
D006801:Humans; D009382:Neoplasms, Unknown Primary / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000556:secondary / Q000601:surgery*