Clinical Gastroenterology Vol.26 No.1(9)

Theme Pancreatic Cancer : Up-to-date
Title ERCP for Pancreatic Cancer
Publish Date 2011/01
Author Ryo Harada Center for Gastroenterology, Teine-Keijinkai Hospital
Author Hiroyuki Maguchi Center for Gastroenterology, Teine-Keijinkai Hospital
Author Manabu Osanai Center for Gastroenterology, Teine-Keijinkai Hospital
[ Summary ] Since its development, ERCP has played a major role in the diagnosis of pancreatic cancer. ERCP allows direct visualization of the main pancreatic duct and its branches, and allows visualization of morphologic abnormalities which are present in most cases of pancreatic cancer. This method of evaluation is very sensitive in experienced hands. However, given the risk of complications such as post-ERCP pancreatitis and the development of less invasive modalities including US, CT, MRI and EUS, there has been an accelerated shift toward ERCP therapy-oriented applications. ERCP is not simply a method for obtaining images of the pancreatic duct. Collection of pancreatic juice, transpapillary biopsy and brush cytology of the pancreatic duct, and intraductal ultrasonography are all possible through the use of ERCP. ERCP is also more sensitive than US, CT, MRI or EUS for detecting pancreatic cancer which may cause strictures in the main pancreatic duct without any masses or pancreatic intraepithelial neoplasia. ERCP-based techniques for the diagnosis of pancreatic cancer are still necessary. As a result, ERCP remains the primary component of imaging modalities. To reduce the risk of ERCP associated complications, patients must be carefully evaluated on an individual basis.
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