Diagnosis of pancreatic carcinoma remains a problem, with symptoms appearing late in the disease. A number of studies investigated the diagnostic utility of various serum markers; however, these markers fail to accurately and reliably diagnose the disease. Endoscopic ultrasound shows some promise for improved staging and diagnosis, and surgical resection remains the only chance for cure. The morbidity and mortality for the procedure continue to decline. The most commonly performed procedure, however, is a palliative one. Generally, for tumors of the pancreatic head, biliary bypass should be performed. Gastric bypass in this setting remains controversial. Chemotherapy remains ineffective in the treatment of pancreatic cancer. Nonsurgical approaches for palliation (eg, endoscopically placed stents) are effective in some patients, but the technique still has significant limitations.
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