[The differential diagnosis of chronic pancreatitis and pancreatic cancer]

Abstract

The following examinations were carried out in patients with chronic pancreatitis and pancreatic cancer: pancreozymin-secretin test, sonography, computed axial tomography, endoscopic retrograde cholangiopancreatography (ERCP) and thin-needle aspiration pancreatic biopsy. In 93.4% of the patients with chronic pancreatitis and in 93.8% of the patients with pancreatic cancer statistically significant changes in the pancreatic exocrine secretion were found after pancreozymin-secretin stimulation. Changes in the pancreatic function cannot be used as a reliable criterion for the differential diagnosis between chronic pancreatitis and pancreatic cancer. The ultrasound examination ensured correct diagnosis in 79% of the patients with chronic pancreatitis and in 76.4% of the patients with pancreatic cancer while the computed tomography gave the correct diagnosis in 80% and 79.4% of the patients respectively. The endoscopic retrograde pancreatography enabled correct diagnosis in 90% of the patients with chronic pancreatitis and in 86.2% of the patients with pancreatic cancer. The thin-needle biopsy revealed malignant cells in 97.5% of the patients with pancreatic cancer. The differential diagnosis between chronic pancreatitis and pancreatic cancer was not decided in 16.2% of the patients examined by sonography, 12% of the patients examined by computed tomography, 7.4% of the patients examined by ERCP and in only 2.5% of the patients examined cytologically.