[Clinical and experimental studies on serum and urine amylase levels in carcinoma of the pancreas and periampullary region].

Serum and urinary amylase level are different between in cases with carcinoma of the pancreas head and in those with carcinoma of body or tail of the pancreas. In this study the relationship between elevation in serum and urinary amylase level and the portion of obstructed pancreatic duct by tumor was analysed in cases with pancreatic carcinoma was analysed and also this was investigated in experimental model of pancreatic duct ligated dog. In patients with carcinoma of the pancreas and periampullary region, the site of obstruction of the main pancreatic duct was estimated by ERP and serum and urinary amylase level were measured. The values of serum amylase level were different according to the site of obstruction of the pancreatic duct by the tumor and in cases with highly elevated serum amylase levels the main pancreatic duct was obstructed within 5cm from the duodenal papilla. Pathology of these cases revealed pancreatic fibrosis derived from pancreatitis accompanied by tumor was closely related to serum and urinary amylase level. In pancreatic ligated dogs similar findings were observed. These data suggested that elevated serum amylase level is due to the pancreatic duct obstruction in cases with carcinoma of the periampullary duodenum.