ABC of diseases of liver, pancreas, and biliary system: Pancreatic tumours
P C Bornman, I J Beckingham
Neoplasms of the pancreas may originate from both exocrine and endocrine cells, and they vary from benign to highly malignant. Clinically, 90% of pancreatic tumours are malignant ductal adenocarcinomas, and most of this article concentrates on this disease.
Endoscopic retrograde cholangiopancreatography is an important investigation in patients with obstructive jaundice. As well as showing biliary and pancreatic strictures, the pathology can be confirmed by taking brushings for cytology or biopsy specimens of the duct for histology. The technique can also be used to place a stent to relieve biliary obstruction. However, it is important not to use this approach before patients are properly selected for treatment.
The diagnosis can also be confirmed by fine needle aspiration guided by ultrasonography or computed tomography, but this investigation has a high rate of false negative results and is rarely necessary. Fine needle aspiration should be avoided in patients with potentially resectable tumours as