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August 20, 1973

Diagnostic Value of Endoscopic Cholangiopancreatography

Author Affiliations

From the Departments of Medicine, Bethesda Lutheran Medical Center and Miller Division United Hospitals, Inc, (Drs. Dickinson and Belsito) and the Department of Radiology, Bethesda Lutheran Medical Center (Dr. Cramer), St. Paul.

JAMA. 1973;225(8):944-948. doi:10.1001/jama.1973.03220360018005

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.