Feb 1, 1996

Endosonography-guided cholangiopancreatography

Gastrointestinal Endoscopy
M J WiersemaP K Frederick


Detailed imaging of the common bile duct and main pancreatic duct is possible with endosonography. Utilizing a custom manufactured flexible needle, we have developed a technique of performing endosonography-guided cholangiopancreatography (EGCP). Of 205 patients undergoing ERCP, complete ductography was not possible in 11 patients. Employing a linear scanning echoendoscope in conjunction with a 4 cm, 22 to 23 gauge aspiration needle, transduodenal cholangiography (n = 10) or transgastric pancreatography (n = 1) was attempted. Successful ductography was possible in 8 of 11 patients (EGCP success 73% vs ERCP 0%, p < .001, Fisher's exact test). In 5 patients, abnormalities identified on EGCP subsequently led to repeat ERCP with precut sphincterotomy. In all of these cases 100% agreement was found between EGCP and ERCP findings. One postprocedure case of pancreatitis occurred in a patient who underwent EGCP at the same setting as the failed ERCP. No early or late complications occurred in the patient group with EGCP performed at a separate setting. EGCP allows an alternative method for obtaining cholangiopancreatography in those patients in whom ERCP is unsuccessful. Further studies are necessary to define the safety and success ra...Continue Reading

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  • Citations96


Mentioned in this Paper

Ultrasonography, Doppler, Color
Endoscopic Ultrasound
Pulmonary Aspiration
Common Bile Duct Diseases
Common Bile Duct Structure
Entire Duct of Wirsung
Main Pancreatic Duct
Endoscopic Retrograde Cholangiopancreatography

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