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Endoscopic Retrograde Pancreatography and Brushing Cytology Using a Guidewire with Special Reference to the Recanalization Method in Patients with Main Pancreatic Duct Obstruction
Author(s) -
TADA Hideki,
TAKEDA Yoshinobu,
SHINDO Hiroaki,
NISHIHARA Tokufumi,
HASHIMURA Naotaka,
TAKASHIMA Tetuya,
NAKAJIMA Shuzo,
HIGASHINO Takeshi,
HONGO Yasushi,
ADACHI Gakuji,
YONEHARA Toru,
NOMURA Toshiyuki,
FUKUMOTO Nobusuke,
MATUMOTO Taizo,
AZUMI Haruhiko,
SHIOZAKI Michiaki,
OSHIBA Saburo
Publication year - 1991
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1991.tb00276.x
Subject(s) - medicine , pancreatic duct , endoscopic retrograde cholangiopancreatography , pancreatitis , lesion , pancreatic cancer , catheter , radiology , bile duct , acute pancreatitis , surgery , cancer
We attempted endoscopic retrograde cholangiopancreatography (ERCP) using guidewires on 32 patients: 16 with main pancreatic duct (MPD) stricture and 16 with MPD obstruction which had been detected by ordinary ERCP. We also performed brushing cytology for pancreatic ductal lesions in 24 of these patients. In 15 of the 16 patients with a MPD stricture, an ERCP catheter was inserted up to the stricture and then the catheter was passed into the proximal MPD through the stricture using a guidewire (recanalization method). In 14 of the 16 patients with a MPD obstruction, the lesion was reached using guidewires. In addition, the recanalization method was possible in 12 of these 14 patients and the pancreatic ductal system proximal to the obstruction was visualized. ERCP using guidewires, especially using the recanalization method, allowed us to obtain detailed information, not only about the lesion itself but also on the pancreatic ductal system proximal to the lesion. Employing these methods, we obtained pancreatograms cliaracteristic of chronic pancreatitis or pancreatic cancer with a high detection rate and could evaluate whether the lesion was benign or malignant even in cases difficult to diagnose using ordinary ERCP. Furthermore, an assessment of the lesion expansion was possible to some degree with the recanalization method. The diagnostic accuracy of brushing cytology of the ductal lesion using guidewires was 79%. Although one subject experienced acute pancreatitis after these procedures, she recovered following conservative treatment. No other serious complications were observed.