The aim of this review is to report results of investigations used in
the staging of pancreatic cancer and draw a practical approach in the
treatment of this cancer. For the diagnosis of pancreatic mass and the
diagnosis of malignancy, ultrasonography and helical-CT seem to be th
e best methods. In cases of non evident malignancy, diagnosis of pancr
eatic cancer can be done by endoscopic retrograde cholangiopancreatogr
aphy and confirmed by transcutaneous biopsy, under CT locating. The di
agnosis of vascular involvement is usually done by helical-CT, while e
ndoscopic ultrasonography gives best results in the diagnosis of lymph
node involvement. The diagnosis of hepatic and peritoneal metastasis
can be difficult, specially in case of small peritoneal deposits, but
accuracy of helical-CT remains high. Grading of these investigations d
epends on the situation after performing ultrasonography and CT scan.
When a pancreatic resection seems to be possible, a surgical treatment
can be directly proposed or preceding by endoscopic ultrasonography f
or lymph node diagnosis, and/or laparoscopy for detection of small per
itoneal deposits.