Abstract
It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small pancreatic cancer (PC), including PC in situ (PCIS) which is undetectable on cross sectional images, endoscopic ultrasonography (EUS) and MRCP serve important roles in detecting local irregular stenosis of the PD or small cystic lesions. Subsequently, ERCP and associated serial pancreatic juice aspiration cytologic examination (SPACE) obtained by endoscopic nasopancreatic drainage (ENPD) may be useful in the diagnosis of very early-stage PC. Further prospective multicenter studies are required to establish a standard method of SPACE for the early diagnosis of PC.
Highlights
It has been reported that diagnosing pancreatic cancer (PC) at an early-stage is challenging.To improve the prognosis of patients with PC, early diagnosis is essential [1,2]
When localized stenosis of the pancreatic duct (PD), caliber change, computed tomography (CT), endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) are recommended
[13]. duct are found, Endoscopic retrograde cholangiopancreatography (ERCP) followed by serial pancreatic juice aspiration cytologic examination (SPACE) is recommended
Summary
It has been reported that diagnosing pancreatic cancer (PC) at an early-stage is challenging. Reported that the 10-year survival rate of patients with resected PC of stage 0 and I revealed a favorable prognosis [4] Indirect findings, such as dilatation of the pancreatic duct (PD) and pancreatic cysts, small tumor lesions difficult to visualize were observed in many cases with stage 0 and I PC [4]. In the last 10 years, certain cases of PCIS have been diagnosed by cytodiagnosis ultrasound-guided fine needle aspiration (EUS-FNA) has been reported to have high diagnostic using pancreatic juice [8,9,10]. It is difficult to diagnose PC without a massrepeated cytodiagnosis pancreatic juice obtained from endoscopic nasopancreatic forming lesion usingusing various image modalities. Satoh et al termed this diagnostic procedure serial pancreatic-juice aspiration cytologic examination (SPACE) [12].
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