Relative Efficiency and Predictive Value of Ultrasonography and Endoscopic Retrograde Pancreatography in Diagnosis of Pancreatic Disease

Clinical usefulness of carbohydrate antigen 19‐9 as a screening test for pancreatic cancer in an asymptomatic population

“…The present study was based on abdominal USG, which has a sensitivity of about 80% in diagnosing pancreatic cancer. Therefore, it is possible that the person exhibiting a normal CA 19‐9 level and a normal USG finding may later be revealed to have pancreatic cancer 23,24 . Moreover, because very small cancers in the early stages have normal CA 19‐9 levels, it is difficult to use CA 19‐9 as a marker for early diagnosis of pancreatic cancer 25,26 …”

“…Therefore, it is possible that the person exhibiting a normal CA 19-9 level and a normal USG finding may later be revealed to have pancreatic cancer. 23,24 Moreover, because very small cancers in the early stages have normal CA 19-9 levels, it is difficult to use CA 19-9 as a marker for early diagnosis of pancreatic cancer. 25,26 Therefore, serum CA 19-9 measurement is not useful as a screening test for pancreatic cancer in the asymptomatic population.…”

Diagnostic retrospective in pancreaticobiliary imaging: Ultrasound and ERCP

“…For biliary tree evaluation ultrasound is highly accurate in detecting gallstones and bile duct dilatation, but ERCP is superior in diagnosing common bile duct stones without biliary tree dilatation. Pitfalls exist for both procedures [1,2,8], particularly in the diagnosis of chronic pancreatitis and differentiation of this entity from pancreatic carcinoma. Percutaneous needle biopsy (which can be performed under ultrasound guidance) and, when that is not available, angiography, are of great help in these cases.…”

“…If the diagnosis remains in doubt, ERCP may then be used to make or confirm the ultrasonographic findings. When used in conjunction, ERCP and ultrasound serve as complementary and exceedingly accurate tools for evaluation of pancreatic and biliary disease [1,[9][10][11][12], many times obviating the need for further radiation exposure or expense for the patient.…”

Diagnosis of Pancreatitis

“…Differential diagnosis between pancreatic carcinoma and chronic pancreati tis may be difficult. The method provides diagnostic information in 60-85% of cases [39,40]. The diagnostic accuracy of ERCP may be increased by cytological examination and determination of lactoferrin in pure pancratic juice.…”