Rapid diagnosis of pancreatic carcinoma.

An algorithmic approach for radiological evaluation of suspected pancreatic carcinoma was applied in more than 200 patients. Outpatient ultrasonography and barium studies of the upper gastrointestinal tract were followed by inpatient endoscopic retrograde cholangiopancreatography, angiography, and percutaneous biopsy. Evaluation took no more than two hospital days and exploratory laparotomy was not needed. Twenty-five patients had carcinoma. The diagnostic accuracy of the algorithm was 96%. Although this method did not increase the diagnosis of resectable tumors, it did result in rapid, accurate diagnosis of pancreatic carcinoma at relatively low cost and with minimum patient discomfort. Hopefully, these results will eventually lead to earlier diagnosis and improved survival.