No abstract

We cannulated the ampulla of Vater using a fiberduodenoscope in combination with X-ray television fluoroscopy while the patient was under general anesthesia. We attempted cannulation in 13 cases in which we observed the ampulla of Vater. We succeeded in examining-nine of them and contrasted the pancreatic duct and the bile duct. In three of these pancreatography was performed successfully and in the other six we defined both the pancreatic duct and the bile duct.In all of these cases, stones were found in the bileduct system and cannulation of the ampulla of Vater was easily performed. After pancreatography, an increase in serum amylase was noted in five cases, which returned to normal between five and seven days after examination. No incidence of pancreatitis was noted. Thus, we performed a direct X-ray examination of the pancreas by means of endoscopic pancreatography and cholangiography. This enable us to detect cancer of the pancreas in its early stage, which has presented a diagnostic challenge for a long time. Fig. 1 Fiberduodenoscope equipped with forceps. Insert: the tip of the apparatus.Moreover, in the future it is likely that this new technical development will be very helpful in examinations of the pancreas and bile-duct system.