Question:
Which is the best investigation for carcinoma head of pancreas?
Which is the best investigation for carcinoma head of pancreas?
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Think of the test that sits next to the pancreas, images tiny tumours and samples them in one go.
Updated On: Jun 23, 2026
- Guided biopsy
- ERCP
- Transduodenal / transperitoneal sampling
- EUS
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The Correct Option is D
Solution and Explanation
Step 1: Carcinoma of the head of the pancreas needs an investigation that both confirms the diagnosis and stages the tumour to judge resectability, ideally with tissue sampling in the same setting.
Step 2: Endoscopic ultrasound (EUS) places the probe in the duodenum right next to the pancreatic head, giving high-resolution images of small tumours, the relationship to vessels, and nodes, and it allows EUS-guided fine-needle aspiration for tissue. This makes EUS the best single investigation. Option (d) is correct.
Step 3: ERCP (b) is mainly therapeutic and diagnostic for ductal obstruction and biliary drainage but is poor for staging and carries pancreatitis risk. Percutaneous guided biopsy (a) risks tract seeding and gives no staging information.
Step 4: Transduodenal or transperitoneal sampling (c) is more invasive with a seeding risk and is not the preferred diagnostic test. Combined with CT for staging, EUS is the best investigation, so the answer is EUS.
Step 2: Endoscopic ultrasound (EUS) places the probe in the duodenum right next to the pancreatic head, giving high-resolution images of small tumours, the relationship to vessels, and nodes, and it allows EUS-guided fine-needle aspiration for tissue. This makes EUS the best single investigation. Option (d) is correct.
Step 3: ERCP (b) is mainly therapeutic and diagnostic for ductal obstruction and biliary drainage but is poor for staging and carries pancreatitis risk. Percutaneous guided biopsy (a) risks tract seeding and gives no staging information.
Step 4: Transduodenal or transperitoneal sampling (c) is more invasive with a seeding risk and is not the preferred diagnostic test. Combined with CT for staging, EUS is the best investigation, so the answer is EUS.
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