Recent endoscopy has made startling progress. Consequently, now endoscopists can diagnose minute (or micro) cancer less than 5 mm in diameter in the digestive organs, particularly in the stomach and the colon. However, early detection of esophageal, biliary tract, or pancreatic cancer is still insufficient in spite of application of a new apparatus or subsidiary method. Among them, regarding recent increment of the cases with pancreatic cancer, it is absolutely necessary for the improvement of a prognosis to reveal small cancer less than 2 cm in diameter, endoscopically. Usefulness of laparoscopy for the diagnosis of hepatocellular cancer is less as compared with hepatic angiography. In this paper, we summarize the present status of gastro-enterological endoscopy in Japan and point clearly the issue to solve in the future.
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