Carcinoma of the pancreatic head area. Diagnostic imaging. Direct cholangiography: ERCP

In case of clinical and radiologic findings suggestive for periampullary cancer, primary goals of ERCP are the observation of the duodenum and the periampullary region and the opacification of biliopancreatic ducts to confirm the diagnosis of neoplastic stricture of biliopancreatic ducts and to establish its origin and extent at the level of the ducts and of the intestinal lumen. Secondarily, during ERCP, histologic and/or cytologic typing of the neoplasm by biopsy sampling and brushing of the lesion or exfoliative cytology of the bile and pancreatic juice, is feasible. At the level of the area of the pancreatic head various types of neoplasms can arise with different prognostic features which require different therapeutic approaches. Endoscopic cholangiopancreatography for its high sensitivity and specificity plays a major role in a correct combined radiodiagnostic imaging.