Diagnostic Value of Endoscopic Cholangiopancreatography

Peroral cannulation of the duodenal papilla for purposes of cholangiography and pancreatography was successfully accomplished in 186 of 202 patients. A fiberduodenoscope was used to locate the duodenal papilla that was then cannulated under direct vision with a Teflon tube. Clinically relevant information was obtained in 71% of 45 jaundiced patients, 46% of 39 patients with recurrent biliary pain, and 81% of 118 patients with suspected pancreatic disease. The procedure was well tolerated. Early diagnosis of biliary tract obstruction resulted in prompt surgical intervention. Individuals with recurrent biliary pain were the most difficult to cannulate, but abnormalities were discovered that had not been demonstrated previously, despite extensive diagnostic efforts. Carcinoma of the pancreas can be diagnosed by endoscopic pancreatography at an early and operable stage.