US-guided percutaneous pancreatography: an essential tool for imaging pancreatitis

The pancreatic duct can be opacified when contrast material is injected through a fine needle percutaneously placed under ultrasound (US) guidance. Percutaneous pancreatography was performed in 63 patients with chronic pancreatitis diagnosed at US or computed tomography (CT). In 52 of these patients, endoscopic retrograde pancreatography (ERP) was unsuccessful or did not enable complete visualization of the duct. The percutaneous pancreatograms and other relevant images of these patients were retrospectively reviewed. Percutaneous pancreatography was successful in 54 patients (86%), in whom it clearly mapped the full ductal anatomy, depicted the relationship between cavities seen at US or CT and the duct, and allowed assessment of duct drainage after antegrade injection of contrast material. This information was not provided by other modalities. Percutaneous pancreatography is a valuable complement to CT, US, and ERP for imaging chronic pancreatitis.