In daily screening, conventional PC is found mainly by direct and/or indirect findings on the main pancreatic duct such as stenosis, interruption, and secondary dilation. Matsukuma and colleagues documented that T1 tumors were found in 10 (7.1%) of 141 IDC cases, and most patients with T1 tumors had some kind of clinical symptoms, as well as poor prognoses . Abnormal findings of the main pancreatic duct were seen in 27 cases (93.1%) of 29 T1 tumors in the study by Furukawa et al. and in 22 cases (95.6%) of 23 T1 tumors on ERCP (endoscopic retrograde cholangiopancreatography) in that by Ohhashi et al. . In the study by Yamasaki et al., ICs preserving mural elastic fibers of the pancreatic duct circumferentially were found in 37 cases (69%) of 54 PCs, and 9.0% of these ICs were in the main pancreatic duct, 64.0% in the large pancreatic duct, and 27.0% in the small pancreatic duct . Therefore, it is important not to miss abnormalities of the main pancreatic duct on pancreatography.
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