Ultrasound imaging of pancreas and biliary tract

Ultrasound and endoscopic retrograde cholangiopancreatography (ERCP) have been compared in the investigation of abnormalities of the pancreas and biliary tract. 208 patients undergoing ERCP were studied prospectively and all had an ultrasound examination in the 24 hours before ERCP. 15 patients had dilated bile-ducts for which no cause was seen on both ultrasound and ERCP; these patients were excluded. 120 of the remaining patients had an abnormal ERCP. In 101 ultrasound findings were in agreement (sensitivity 84%). 73 patients had a normal ERCP with ultrasound agreement in 70 (specificity 95%). The sensitivity and specificity of ultrasound is now such that patients can proceed directly to ERCP for diagnostic confirmation and papillotomy or endoprosthesis insertion where appropriate.