Pancreatic carcinoma. Diagnostic and prognostic implications of a normal pancreatogram.
BACKGROUND
The aim of this study was to establish the implications of a normal pancreatogram in patients with pancreatic cancer.


METHODS
We reviewed all ERCP done at our institution for the period 1983-92 and studied 62 of 727 patients who had a diagnosis of pancreatic (n = 416) or biliary (n = 311) cancer but a normal pancreatic duct.


RESULTS
Thirty of the 62 patients had pancreatic cancer. In 15 cases, the ERCP diagnosis was incorrect, and in 19 cases, Santorini's duct was not visualized. Other imaging revealed a pancreatic head mass in 25 patients (2.5->7 cm). Only three patients had resectable tumors; another eight underwent laparotomy. Five had bypass surgery, 10 required biliary stenting, and nine had no treatment. Four patients died in hospital, and eight were lost to follow-up. In the remaining 18 patients, median survival was 7 months (range, 1-30 months).


CONCLUSIONS
A normal pancreatogram does not exclude the diagnosis of pancreatic cancer, nor does it confer a better prognosis.
Hewitt
P M
PM
Surgical Gastroenterology and Department of Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Beningfield
S J
SJ
Bornman
P C
PC
Krige
J E
JE
van Wyk
M E
ME
Terblanche
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D014057:Tomography, X-Ray Computed