CYSTIC NEOPLASMS OF THE PANCREAS - EVALUATION WITH ENDOSCOPIC RETROGRADE PANCREATOGRAPHY

Images from endoscopic retrograde pancreatography performed in 38 pati ents with cystic pancreatic neoplasms were reviewed to determine wheth er they might allow differentiation of malignant from benign lesions. Twenty-three patients had histologically proved benign lesions; 15 had frankly malignant lesions. Images were classified into four groups on the basis of the appearance of the pancreatic duct: (a) normal, (b) s howing narrowing or draping; (c) showing communication with a cystic s pace, and (d) showing obstruction. Of the 23 patients with benign lesi ons, eight had normal studies, 11 had studies showing narrowing or dra ping, three had studies showing communication, and one had a study sho wing obstruction. Of the 15 patients with malignant lesions, one had a normal study, three had studies showing narrowing or draping, two had studies showing communication, and nine had studies showing obstructi on. Overall, there was a significant difference in the rates of pancre atographic findings for benign and malignant tumors (P = .001). Althou gh no finding proved to be an absolute indicator of benign or malignan t disease, obstruction occurred with 60% of malignant tumors and was s een with only one benign lesion (4%).