Fujita Naotaka, Noda Yutaka, Kobayashi Go, Kimura Katsumi, Ito Kei
Department of Gastroenterology, Sendai City Medical Center, Miyagi, Japan.
Pancreas. 2004 Apr;28(3):279-81. doi: 10.1097/00006676-200404000-00012.
Since its development, endoscopic retrograde cholangiopancreatography (ERCP) has been playing a major role in the diagnosis of pancreatic diseases. The recent development of magnetic resonance cholangiopancreatography has accelerated the shift in the role of ERCP toward more therapy-oriented applications. In the diagnosis and treatment of curable pancreatic cancer, however, ERCP remains the mainstay of imaging modalities. ERCP is not simply a method with which to obtain x-ray images of the pancreatic duct. Collection of pure pancreatic juice, transpapillary biopsy/brush cytology of the pancreatic duct, intraductal ultrasonography, and peroral pancreatoscopy are all performed based on the ERCP technique. Endoscopic ultrasonography (EUS) has a high spatial resolution and provides tomographic images of the pancreas and its neighboring organs. EUS is now widely used in evaluation of the local extent of pancreatic cancer and the differential diagnosis of cystic lesions of the pancreas. EUS-guided fine needle aspiration biopsy/cytology is performed to obtain a histologic diagnosis before beginning chemotherapy. Although the number of pancreatic cancer patients who are candidates for surgery is limited at present, there is an increasing need for ERCP-based techniques in both the diagnosis and treatment of pancreatic neoplasms.
自内镜逆行胰胆管造影术（ERCP）问世以来，它在胰腺疾病的诊断中一直发挥着重要作用。磁共振胰胆管造影术的最新发展加速了ERCP的作用向更侧重于治疗的应用转变。然而，在可治愈胰腺癌的诊断和治疗中，ERCP仍然是主要的成像方式。ERCP不仅仅是一种获取胰管X线图像的方法。基于ERCP技术还可进行纯胰液采集、胰管经乳头活检/刷检细胞学检查、胰管内超声检查以及经口胰管镜检查。内镜超声检查（EUS）具有高空间分辨率，可提供胰腺及其邻近器官的断层图像。EUS目前广泛应用于评估胰腺癌的局部范围以及胰腺囊性病变的鉴别诊断。在开始化疗前，可通过EUS引导下细针穿刺活检/细胞学检查来获得组织学诊断。尽管目前适合手术的胰腺癌患者数量有限，但在胰腺肿瘤的诊断和治疗中，基于ERCP的技术需求日益增加。
