Hall T J, Blackstone M O, Cooper M J, Hughes R G, Moossa A R
Ann Surg. 1978 Mar;187(3):313-7. doi: 10.1097/00000658-197803000-00018.
In a prospective study of 112 patients suspected of periampullary cancer endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed in 87 patients (78%). Technical failures were due to gastric outlet obstruction in four patients and inability to cannulate the ampulla of Vater in 21 patients. Successfully performed ERCP had both a high sensitivity (92%) and specificity (90%) for periampullary cancer. The few errors in pancreatogram interpretation were due to juxta-ductal cancers and difficulty in differentiating duct changes of cancer from those of chronic pancreatitis. Pancreatic cytology, performed in 21 patients, was reliable, diagnosed two pancreatic cancers when the pancreatogram failed and, if used routinely, assists interpretation of the pancreatogram. Retrograde cholangiography provided a correct diagnosis in six jaundiced patients with normal pancreatograms. Three complications of ERCP occurred in this series.
在一项针对112例疑似壶腹周围癌患者的前瞻性研究中，87例患者（78%）成功进行了内镜逆行胰胆管造影（ERCP）。技术失败的原因包括4例胃出口梗阻和21例无法插入十二指肠乳头。成功进行的ERCP对壶腹周围癌具有较高的敏感性（92%）和特异性（90%）。胰管造影解释中的少数错误是由于导管周围癌以及难以区分癌性导管改变与慢性胰腺炎的导管改变。21例患者进行的胰腺细胞学检查可靠，在胰管造影失败时诊断出2例胰腺癌，若常规使用，有助于胰管造影的解释。逆行胆管造影对6例胰管造影正常的黄疸患者做出了正确诊断。本系列中发生了3例ERCP并发症。
