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EXPERIENCE WITH ENDOSCOPIC RETROGRADE PANCREATICOGRAPHY

H. ANACKER M.D., H.-D. WEISS M.D., B. KRAMANN M.D., and N. RUPP M.D.

Review of our experience with the endoscopic retrograde pancreaticography is based on 650 examinations.

An anatomic nomenclature of the pancreatic duct system is proposed. In the course of the normal evacuation of the pancreatic duct 3 different phases are distinguished. In papillary stenosis and in papillary spasm these phases are changed pathologically and the total evacuation time is prolonged. In chronic pancreatitis there are irregularities of the outline of the course of the duct with progress of the disease; there are ectasias, solitary or multiple stenoses, and deformities of the side ducts.

Stones in the pancreatic main duct appear as defects in the contrast medium filling.

The special value of the diagnostic proof of pancreatic abscesses and pseudocysts shown by contrast medium extraductation is discussed as regards surgical intervention.

The duct changes seen in pancreatic carcinoma are often similar to those of chronic pancreatitis.

The normal appearance of the pancreatic main duct and side ducts between the tumor and papilla, and evaluation of all clinical and radiologic findings frequently allow the right differential diagnosis.


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