Endoscopic retrograde cholangiopancreatography: the diagnosis of hepatobiliary and pancreatic carcinoma
Sewell, R.B.; Levin, L.R.
Australasian Radiology 22(2): 132-138
1978
ISSN/ISBN: 0004-8461 PMID: 747564 Document Number: 133814
In 68 patients subjected to endoscopic retrograde cholangiopancreatography (E.R.C.P.), 17 had hepatobiliary or pancreatic malignancy. In 14 of the 17 patients (82%) the diagnosis of malignancy was established at E.R.C.P., and in a further case malignancy was suspected. Malignancies found were carcinoma of the pancreas (11), periampullary carcinoma of the pancreas (1), cholangiocarcinoma (2) and secondary carcinoma in the pancreas (1). The 2 patients whose tumors were not diagnosed at E.R.C.P. were subsequently found to have hepatomas. In 5 instances, the diagnosis of tumor was made by endoscopy and biopsy alone; in the other 10 cases, diagnosis depended on the radiological features. The 7 pancreatic malignancies showed stenosis (3) or obstruction (4) of the pancreatic duct, and in 4 cases there was an associated abnormality on the cholangiogram. The 2 cholangiocarcinomas had strictures (2) and obstruction (1) of the bile duct, whilst the secondary carcinoma of the pancreas presented a filling defect on the pancreatogram. Malignancy of the pancreas and extrahepatic biliary tree may be accurately diagnosed by E.R.C.P.