Biochemical Tests: Pancreas is a compound gland, about 15 cm long, that lies behind the stomach. Examination of the secretions of the pancreas can give an idea about cancer of the pancreas. For this purpose, a special double-lumen tube is swallowed and then screened into position in the duodenum, i.e. the first of the three parts of the small intestine. It has a weighted bulbous end and contains two sets of holes, one for duodenal and the other for gastric aspiration. The latter set of holes prevents contamination of the duodenal fluid that is aspirated.
After a short period allowed for stabilization, pancreozymin is injected and the duodenal aspirate collected for 30 minutes. The volume of aspirate and concentration and output of bicarbonate, amylase, lipase and trypsin are then measured and calculated. Patients with cancer of the pancreas produce low volumes and concentration of enzymes.
Fresh aspirate is examined for cancer cells by the Papanicoloau method. Interpretation, however, is difficult and requires an experienced cytologist.
Ultrasound and CT Scans: These are both useful methods in the diagnosis of pancreatic disease. Each method can differentiate solid from cystic lesion greater than 2.5 cm in size and the success rate in diagnosis is around 70 per cent.