title: Diagnosis of small pancreatic cancer by endoscopic balloon-catheter spot pancreatography: an analysis of 29 patients.
abstract: OBJECTIVE
  The diagnosis of small pancreatic cancer remains difficult. The present study describes the diagnostic value of endoscopic balloon-catheter spot pancreatography for small pancreatic cancer.
  
  
  METHODS
  Since April 1984, balloon spot pancreatography has been used to detect small-sized pancreatic cancer in patients having possible symptoms or findings of obstructive pancreatitis.
  
  
  RESULTS
  A resection was performed on 175 of 416 patients with conditions diagnosed as pancreatic cancer. Of the 175 patients, 23 (13%) had invasive carcinoma 2 cm or smaller based on histological measurements, 3 intraductal papillotubular adenocarcinoma, and 3 carcinoma in situ (CIS). Regarding invasive carcinoma, balloon pancreatography displayed duct abnormalities diagnosed as carcinoma in 20 of 22 patients, whereas carcinoma was suggested in 2. A definite diagnosis was obtained based on the findings of main duct stenosis or obstruction with marked stricture of the branch ducts (n = 18) and a filling defect in the main duct (n = 2). Moreover, this pancreatogram demonstrated an intraductal filling defect in 2 of 3 with intraductal carcinoma and dead twiglike findings in the branch ducts in 1 of 3 with CIS.
  
  
  CONCLUSIONS
  Balloon spot pancreatography is an essential tool for the diagnosis of small ductal pancreatic cancer, and it also makes it possible to locate CIS lesions of the branch ducts.
authors.affiliation: Department of Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. s-ikeda@fukuoka-u.ac.jp
authors.forename: Seiyo
authors.initials: S
authors.lastname: Ikeda
authors.forename: Kensei
authors.initials: K
authors.lastname: Maeshiro
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ryu
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogata
authors.forename: Yohichi
authors.initials: Y
authors.lastname: Yasunami
authors.forename: Yoshifuku
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hamada
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010195:Pancreatitis / Q000175:diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity