Diagnostic efficacy of endoscopic ultrasound tomography in pancreatic cancer and cholestasis.

By direct access to the target organs and by improved detail resolution, endoscopic ultrasound tomography (EUT) broadens the range of sonographic diagnostics. In this preliminary study, the accuracy of EUT was tested in 34 patients with suspected pancreatic carcinoma and/or painfree jaundice. In all 10 patients with pancreatic carcinoma and in all 6 patients with chronic pancreatitis, the diagnosis made by EUT was correct. Three patients with benign tumors of the pancreas were also diagnosed correctly. The diagnostic sensitivity of EUT in pancreatic cysts was in 4 of 5 cases 80%, in dilatations of the main pancreatic duct in 10 of 11 cases 91%, and in cholestasis in 14 of 15 cases 93%. All 5 common bile duct concrements and all 3 tumors of the papilla Vateri were diagnosed by EUT. The differential diagnosis between pancreatic tumor and pancreatitis was improved by EUT in 1 of 18 cases. In the region of the papilla Vateri, EUT was superior to conventional UT in the diagnosis of ampullary concrements and papillary tumors in 6 of 8 cases (4/5 and 2/3, respectively). EUT could become an important complementary diagnostic method for disorders of the pancreas and the common bile duct with a particular sensitivity for the region of the papilla Vateri.