Failure of new diagnostic aids in improving detection of pancreatic cancer at a resectable stage.

This study was undertaken to verify whether new diagnostic tools (angiography, endoscopic retrograde cholangiopancreatography, ultrasonography, and computed tomography) have improved the detection of pancreatic cancer at a resectable stage. Two groups of patients with histologically ascertained cancer of the pancreas were examined. The first consisted of 54 cases investigated before the clinical application of the four above-mentioned techniques and the second of 74 cases investigated thereafter. Cancer resectability was judged by a surgical team at the time of laparotomy according to preestablished criteria. No significant difference was found between the number of resections and other procedures in the two groups. On the other hand exploratory laparotomies performed exclusively for diagnostic purposes were significantly (P less than 0.01) reduced in the second group. On the basis of these results one may conclude that new diagnostic aids are useful and reliable in the preoperative detection of pancreatic cancer, but their introduction into clinical practice has not permitted an earlier diagnosis of the disease and therefore there has been no important increase in its resectability.