胰头、壶腹癌的早期诊断至今仍是临床上较为困难的问题,我院近5年收治无黄疸期胰头、壶腹癌4例,现就其早期诊断体会报告如下。临床资料例1.男,33岁。心窝部及右上腹闷胀痛伴食欲减退7个月。查体无黄疸,肝大肋下3cm,胆囊大。黄疸指数6单位,转肽酶259单位,血糖(79mg%),尿糖阴性,糖耐量试验正常。B 超:肝内外胆管扩张,左肝管内径2.1cm,肝总管2.9cm,胆总管2.9cm;胆总管末端未显示病变,胰头大小正常。PTC:肝内外胆管明显扩张,胆总管末端完全截断。术前诊断:壶腹癌。术中见十二指肠乳头部2×2cm 肿物,活动。经十二指肠行肿物穿刺细胞学检查,找到癌细胞。切开十二指肠见肿物呈菜花样,切取部分活组织做冰冻 The early diagnosis of pancreatic head and ampullary cancer is still a clinically difficult problem. In our hospital for the past 5 years, there were 4 cases of pancreatic head and ampullary carcinoma without jaundice. Now we report on the results of its early diagnosis. Clinical data Example 1. Male, 33 years old. The heart and the right upper abdomen were painful and discomforted with loss of appetite for 7 months. The examination showed no jaundice, and the liver was 3 cm under the ribs and the gallbladder was large. Astragalus index 6 units, transpeptidase 259 units, blood glucose (79mg%), urine glucose negative, glucose tolerance test is normal. B-ultrasound: Intrahepatic bile duct dilatation, left hepatic duct diameter 2.1cm, hepatic duct 2.9cm, common bile duct 2.9cm; common end of common bile duct showed no lesion, pancreatic head size was normal. PTC: Intrahepatic and extrahepatic bile ducts are significantly dilated and the end of the common bile duct is completely truncated. Preoperative diagnosis: ampullary cancer. During the operation, a 2×2cm tumor of the duodenal papilla was seen. Duodenal tumors were taken for cytological examination to find cancer cells. Cut the duodenum and see the tumor as a cauliflower, cut some of the living tissue to make a frozen