Cytodiagnosis of pancreatic and biliary cancer by endoscopic duct aspiration.

Duct aspiration was performed immediately after endoscopic retrograde cholangiopancreatography (ERCP) in 33 patients with ductal changes which were suggestive of pancreatic or biliary cancer. Malignant cells were identified in 10 of 17 patients (60%) with cancer of the pancreas, and in two of 10 patients (20%) with cancer of the biliary tract. Atypical cells were identified in additional patients with cancer, but cytological characteristics did not permit a definitive diagnosis. No false positive diagnoses were made. Duct aspiration is a relatively simple extension of ERCP, and enhances diagnostic accuracy, particularly in patients with carcinoma of the pancreas.