Endoscopic retrograde cholangiopancreatography in the preoperative diagnosis of pancreatic neoplasms associated with cysts

C. Wright Pinson, Clifford W. Deveney, J. Lawrence Munson

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Neither computed tomography (CT) nor ultrasonography reliably distinguishes neoplastic from non-neoplastic pancreatic cysts. More invasive tests such as angiography or biopsy fail to differentiate these lesions in up to a third of patients. Because appropriate treatment differs greatly for these two classes of lesions, the clinician requires a more accurate means of confirming or excluding neoplasia. In an effort to refine the preoperative diagnosis of pancreatic cysts and evaluate the utility of endoscopic retrograde pancreatography (ERCP), we evaluated 11 patients with proven pancreatic neoplasia associated with cysts who underwent preoperative ERCP and CT scanning. Four patients had microcystic cystadenomas, two had a mucinous cystadenoma, one had a mucinous cystadenocarcinoma, and four had adenocarcinomas associated with cysts. CT identified a pancreatic cystic lesion in each patient. In all patients, ERCP showed either focal irregular narrowing, occlusion, or displacement of the main pancreatic duct at the corresponding location without the ductal changes of chronic pancreatitis. This helped to preoperatively differentiate these lesions from pseudocysts, hastening appropriate operation, obviating further testing and consultation, and aiding the intraoperative surgical strategy.

Original languageEnglish (US)
Pages (from-to)510-513
Number of pages4
JournalThe American Journal of Surgery
Volume159
Issue number5
DOIs
StatePublished - May 1990

ASJC Scopus subject areas

  • Surgery

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