Endoscopic diagnosis of pancreatic cancer using intraductal ultrasonography

Background/Aims: At present developed modalities are not sufficient for det ecting early stage pancreatic cancer. We previously reported the clinical u sefulness of intraductal ultrasonography in various pancreatobiliary diseas es. In the present study we assessed the usefulness of intraductal ultrason ography in diagnosing pancreatic cancer. Methodology: Thirty-one patients with pancreatic cancer were examined by in traductal ultrasonography. We approached the main pancreatic duct (pancreat ic duct-intraductal ultrasonography) in 24 of 31 patients and the bile duct (bile duct-intraductal ultrasonography) in 20 patients with pancreatic can cer. We compared the diagnostic ability of pancreatic duct-intraductal ultr asonography with that of extracorporeal ultrasonography, computed tomograph y, endoscopic ultrasonography or endoscopic retrograde pancreatography. We examined the usefulness of bile duct-intraductal ultrasonography in diagnos ing tumor invasion to the bile duct. Results: Pancreatic duct-intraductal ultrasonography was able to demonstrat e a tumor in 22 of 24 patients. Extracorporeal ultrasonography, computed to mography, endoscopic ultrasonography or endoscopic retrograde pancreatograp hy detected tumors in 26, 27, 29, 29 of 31 patients, respectively. In two p atients, only intraductal ultrasonography could demonstrate a tumor, which was not detected by any other modalities. We examined bile duct invasion of the tumor according to our grading system. The overall accuracy rate was 9 0%. No complications were noted in any patients throughout the study period . Conclusions: Intraductal ultrasonography is useful to diagnose pancreatic c ancer, and it is suggested that it should be actively performed after endos copic retrograde pancreatography.