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ENDOSCOPIC PANCREATO-CHOLANGIOGRAPHY

A PRELIMINARY REPORT ON TECHNIQUE AND DIAGNOSTIC SIGNIFICANCE

KUNIO OKUDA M.D.1, NAIKI SOMEYA M.D.2, ATSURO GOTO M.D.2, TADAHIKO KUNISAKI M.D.2, TAKESHI EMURA M.D.2, MASATAKE YASUMOTO M.D.2, and YUTAKA SHIMOKAWA M.D.3

1 Professor of Medicine, Chiba University School of Medicine, Chiba.
2 Second Department of Medicine (Director: Prof. Nobuhiko Okabe), Kurume University School of Medicine, Kurume.
3 Assistant Professor, Second Department of Medicine, Kurume University School of Medicine, Kurume.

Using an Olympus JF-B type fiberduodenoscope, retrograde pancreatography and/or choledochography has been carried out on 47 subjects.

The Vater papilla was cannulated in 86 per cent of the attempts, and in 83 per cent the pancreatic ductogram was obtained. The common duct was visualized less frequently.

There has been no accident, although in about one-half of the subjects, a transient rise in serum amylase occurred shortly after the procedure, which seemed to be avoided by reducing the amount of contrast medium to be injected and minimized by the preventive use of Trasylol.

Although evaluation of the diagnostic significance of retrograde pancreatography is yet to be determined, it was helpful in the diagnosis of chronic pancreatitis and carcinoma of the pancreas, and may prove to be a reliable measure in patients with suspected pancreas and biliary tract diseases, if carried out properly.

Further improvement in instrumentation, technique and skill may be expected. Accumulation of clinical data is mandatory, at the moment, to improve the interpretation of the ductogram.


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