Internal medicine

Radiology

Pancreatic disease

Endoscopic retrograde cholangiopancreatography

Pancreas

Gold standard (test)

Biology

Cancer

Magnetic resonance imaging

Stage (stratigraphy)

Paleontology

Pancreatitis

Magnetic resonance cholangiopancreatography

Pancreatic duct

Stenosis

Pancreatic cancer

Medicine

Diagnostics

It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small pancreatic cancer (PC), including PC in situ (PCIS) which is undetectable on cross sectional images, endoscopic ultrasonography (EUS) and MRCP serve important roles in detecting local irregular stenosis of the PD or small cystic lesions. Subsequently, ERCP and associated serial pancreatic juice aspiration cytologic examination (SPACE) obtained by endoscopic nasopancreatic drainage (ENPD) may be useful in the diagnosis of very early-stage PC. Further prospective multicenter studies are required to establish a standard method of SPACE for the early diagnosis of PC.

Roles of ERCP in the Early Diagnosis of Pancreatic Cancer