Abstract
We have attempted to perform the Endoscopic Retrograde Pancreato parenchymography (ERPP) in 85 cases. In these cases, the contrast medium was the Sodium Iothalamate mixed with Menatetrenone. And we compaired these 85 cases with 80 cases of usual FRCP. As a result, parenchymogram (good and fair) was obtained in 32 cases (38%) on ERPP and in 17 cases (12%) on usual ERCP. The ERPP was obviously superior to the usual ERCP in the visualization of the pancreatic parenchyma. But, we could not obtain the higher rate of visualization of the pancreatic parenchyma as in the reports of Yoshimoto et al. or Akasaka et al.. On the other hand, we studied the diagnostic ability of the parenchymogram about 49 cases with parenchymogram on ERPP and usual ERCP. We considered that we could not easily differentiated the malignant pancreatic diseases, such as pancreatic carcinoma or pancreatic cyst adenocarcinoma, from the benign pancreatic diseases, such as chronic pan-creatitis or agenesis of the dorsal pancreas, by the ERPP alone. And we found that we could not easily discriminate the large malignant tumor of the retroperitoneum from the pancreatic carcinoma though we performed the ERPP. We concluded that we should perform parenchymography and so called ‘branchgraphy’ at the same time in the diagnosis of the pancreatic diease, especially for the small pancreatic carcinoma.
