Endosonographic possibilities in the pancreatobiliary area

ES is certainly the most accurate technique presently available for visualizing small lesions in the pancreas and (distal) bile duct. However, this technique can at present not be utilized for improving the earlier diagnosis of pancreatic carcinoma but is of great help in the preoperative localization of pancreatic endocrine tumours. ES makes significant contributions to the preoperative loco-regional staging of pancreatic, ampullary and distal biliary malignancies, but it has distinct limitations in large masses and more remote areas (superior mesenteric vein) and in the differentiation between malignant and inflammatory lesions.