Endoscopic pancreatocholangiography (EPCG) with the fiberduodenoscope was successfully performed in 73 cases with a rate of 85%. Of these 65 were pancreatographies, 25 were cholangiographies and both were obtained on 17 examinations.
1) The mean maximum diameter of the main pancreatic duct (MPD) in 50 pancreatograms interpeted as normal was 3.3±0.8mm. As a rule, the ducts were wider in male and patients over the age of 50 than in female and younger subjects.
2) Type of the course of the main pancreatic duct was classified into the ollowing four types. The ascending and horizontal types were most often observed, while the sigmoid and decending types were less often found.
3) The mean length of MPD in 50 pancreatograms interpreted as normal was 16.3± 2.6cm. A tendency to be longer in the length of the duct in male and younger subjects was noted.
4) The ampulla of MPD was found in four cases or 8.0% of 50 cases.
5) The duct of Santorini was visualized in 20 cases or 40% of 50 cases, and the mean length of the duct was 2.4±0.5cm and the mean maximum diameter of the duct was 1.4±0.5mm.
Ampulla-like dilatation of the duct of Santorini was seen in 7 cases or 35% of the 20 cases and the mean length was 3.0±1.3mm and the mean maximum diameter was 2.7±1.4mm.
6) Opacification of the fine pancreatic ducts and acinar tissue were successful in 23 or 35.4% of 65 pancreatograms and in 15 or 65.2% of the 23 cases complate opacification of the whole pancreatic glands was obtained.
7) Of 25 cases with endoscopic cholangiogram (ECG) the gall bladder was visualized in 17 cases, the hepatic ducts and the intrahepatic bile ducts in 15 cases. The mean maximum diameter of the common bile duct in normal ECG was 6.7±0.9mm, 5.3±1.2mm in normal EPCG.
8) The common channel was revealed in 13 or 76.5% of 17 cases with EPCG, and the separate type of the ducts in 4 cases or 23.5%. The mean length of the common channel was 12.2±4.1mm, the mean maximum diameter of the channel was 4.8±2.0mm.
9) In about half the cases with opacified MPD and the branches and in all cases demonstrating the fine pancreatic ducts and acinar tissue a trandient, mild to moderate elevation in serum amylase occurred after the examination. However, all elevations of serum amylase returned to normal within 48 hours and the clinical picture of acute pancreatitis was presented in none. Antibiotics were administered to all cases and trasylol was also given to some cases.
10) Abnormalities of pancreatic duct system were seen on 9 or 13.8% of 65 EPG; four of pancreatic carcionma, one of pancreatic tumors, one of compression by an extrinsic tumors mass, two of advrnced chronic pancreatitis and one of minimal chronic pancreatitis.
In 6 or 24% of 25 ECG abnormal findings were demonstrated; four of cholelithiasis and choledocholithiasis, one of tumor of the common bile duct and one of metastatic liver carcinoma.
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