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DELAYED DUCTAL DRAINAGE: AN ENDOSCOPIC PANCREATOGRAPHIC SIGN OF CARCINOMA OF THE HEAD OF THE PANCREAS

ALPHONSO A. BELSITO M.D., GLEN G. CRAMER M.D., and PAUL B. DICKINSON M.D.

Sixteen patients with carcinoma of the pancreas have been examined by duodenoscopy and varying degrees of retrograde pancreatography. A standardized roentgenographic technique consisting of immediate filming after injection and 20 minute follow-up studies was used to assess contrast medium retention. On the basis of this standardized methodology, failure of the pancreatic duct to drain on a 20 minute delayed film appears to be indicative of carcinoma of the head of the pancreas.

Benign noncalculous chronic pancreatitis may have a pancreatographic appearance anatomically similar to carcinoma, but is distinguished by its non-obstructed draining characteristics. All of the patients with delayed ductal drainage had confirmed adenocarcinoma of the head of the pancreas. Two of these lesions were small, resectable carcinomas.


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