Investigative approaches to the problem of pancreatic cancer.

A prospective study of 134 patients suspected of having pancreatic cancer is reported. Ultrasonography and duodenal drainage studies are the best initial investigations. Endoscopic retrograde cholangiopancreatography with cytological examination is the test most likely to provide a definitive diagnosis. Arteriography is essential before laparotomy to delineate anomalies in the foregut vasculature. Pancreatic oncofetal antigen is the only tumour marker that is useful in diagnosis and in monitoring therapy.