Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer: Experiences with 54 Cases

Abstract

Pathological alterations of the ductal system found during ERCP in 1082 examinations were due to pancreatic carcinoma in 54 patients. The diagnosis was confirmed by laparotomy or autopsy. Predominant findings in 42 patients were stenoses, prestenotic dilatation, caliber variation, stop of contrast medium and ductal displacement in pancreatography. In 28 cholangiograms stenoses were most common which were localized in one third of the cases in the proximal common bile duct. Four types may be differentiated: a stenosing type, an obstructed type, a tapering type and a cavernous type. The stenosing type can be divided in a form with and without interruption of the contrast medium column. A precise differential diagnosis between pancreatic carcinoma and chronic pancreatitis is not possible but a long stenosis with or without stop of the contrast medium speaks in favour of a tumorous process.