Abstract
Endoscopic Pancreato-Cholangiography (E. P. C.G.) has already become popular as an essential diagnostic method of pancreatic and choledochal diseases. And recently they try not only to analyze the pancreatocholangiograph, but the cytology by collecting the pancreatic juice and pan-creas function test under duodenoscopy, and pancreato-cholangioscopy by introduction of a small fiberscope through the duodenoscope into the choledochus and pan-creatic duct directly. However, there still remains a lot of problem on the reading of E.P.C.G. radiograph as well as on the technique and diagnostic evaluation of direct pancreatic juice collection test. In order to supply dificiencies in those diagnostic method and to utilize the technique, we have been studying the endoscopic continuous pancreato-choledoch catheter rema-ining method. This method is performed as follows: 1. Insert the long catheter into the choledochus or pancreatic duct under observation with duodenos- cope. 2. Extract the duodenoscope only while remaining the catheter in the same position. 3. Through the catheter remained various examina- tion and diagnostic procedure can be performed at any time needed. We have succeeded in remaining the catheter for 55% in the cases of pancreatic duct and 90% of choledochus. With the help of this method, selective cytology and pancreatic secretion test have become facilitated, and the other morphological examination such as low-tentional duodenography and selective angiography, and also simul-taneous pancreatography have become possible. And during our study we found in a few case there were rise in amylase consistency and the increase of pancreatic in the midnight when we performed the continuous pancreatic juice collection. From these results it can be said this method can be expected useful for the further diagnosis. Also this endoscopic continuous choledocho catheter remaining method was useful for the removal of choledo-chal stones, quick doreinage to prevent the acute choledo-chitis, and for the utilization as a guiding catheter. In its complication we found a proclem of rise of blood amylase, and felt there still remains a room for the impr-ovement of examination technique and the sellection of the cases.
