Evaluation of endoscopic retrograde cholangiopancreatography and angiography in the diagnosis of pancreatic carcinoma.

A series of 118 patients with suspected pancreatic disease was studied by endoscopic retrograde cholangiopancreatography (ERCP). Angiography was subsequently performed in 30 of these patients. ERCP was 95% accurate in the prospective diagnosis of pancreatic carcinoma. This study suggests that angiography is valuable in determining tumor resectability following ERCP diagnosis of pancreatic carcinoma. Angiography may obviate the need for exploratory laparotomy in patients with unresectable tumors and encourage aggressive treatment of resectable lesions. Patients with a high clinical suspicion of pancreatic disease should have angiography if the ERCP is normal, equivocal, or there is a cannulation failure.