Erste Erfahrungen mit der duodenoskopischen retrograden Pankreatikographie in der Diagnostik der chronischen Pankreatitis

Wiesner, Walter; Hd, Weiss; Anacker, H

doi:10.1055/s-0028-1107482

Cited by 6 publications

(2 citation statements)

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“…On the other hand a normal duct does not rule out chronic pancreatitis with parenchymal destruction. We do, however, not believe, as Wiesner et al(12) do that marked variations in calibre size and irregular outlining of the duct is compatible with normal histology of the gland.Data on length and, more important, on width in "normal" pancreatograms may help to establish guidelines for the analysis of pancreatograms in chronic pancreatitis with only minor ductal changes.…”

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confidence: 63%

Anatomy of the Pancreatic Duct A Duodenoscopic-Radiological Study

Classen¹,

Hellwig²,

Rösch³

1973

Endoscopy

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Diagnosis of pathological changes in endoscopicradiological pancreatograms relies on the knowledge of normal anatomy of the pancreatic duct. For this purpose pictures of patients without pancreatic disorders were evaluated. The values are given in medians and decile ranges (i.e. 10-90"/o). The lenght of the pancreatic duct (n = 48) was calculated with a median 1 = 20.1 cm (decile range D.R. = .5.4 cm). Minor variations of the duct caliber seem to be normal. The values for maximal and minimar width in the three main segments of the pancreatic duct were: head: Tr max. = 4.8 (D.R. = 2.3 mm), 11 mm. = 3.4 (DR. = 1.7 mm). Body: 11max. 3.5 (D.R. = 1.3 mm), X min. = 2.7 (D.R. = 1.1 mm). Tail: 11max. 2.4 (D.R. = 0.9 mm), 3-c min. = 1.6 (D.R. = 0.9 mm). In addition the topography in correlation to the spine and the course of the pancreatic duct were studied. In 54% of the patients Vater's papilla was located in the middle third of the second portion of the duodenum. Key-Words: Duodenoscopy, pancreaticography, pancreatic duct anatomy.With the advance of fiberoptic duodenoscopes cannulation of Vater's papilla and retrograde filling of the normal and diseased pancreatic duct became a routine procedure with minimal risks. Hitherto available data on the anatomy of the pancreatic duct were based on autopsy studies or were done intraoperatively under unphysiological conditions. Endoscopic pancreaticography is performed in a conscious patient without any abnormality of the periampullar region which might affect the anatomy of the pancreatic duct. * D 29. With support by Stiftung Volkswagenwerk. Endoscopy 5 (1973) 14-17 C) Georg Thieme Verlag, Stuttgart Anatomie des Pankreasganges. Eine duodenoskopisdi-radiologische Studie Die Diagnostik pathologischer Befunde bei der retrograden Pankreatographie setzt die Kenntnis der normalen Anatomie des Pankreasgangsystems voraus. Zu diesem Zweck wurden Pankreatogramme von Patienten ohne Anhalt für Pankreaserkrankungen ausgewertet. Die durchschnittliche Lange des Pankreasganges, ermittelt bei 48 Patienten, betrug-20,1 cm mit einem Dezilbereich von 5,4 cm. Kleinere Kaliberschwankungen gehören zum Normalbefund. Maximale und minimale Gangbreite wurden im Kopfbereich mit 4,8 bzw. 3,4 mm gemessen, im Korpusabschnitt mit 3,5 bzw. 2,7 mm und im Schwanzbereich mit 2,4 bzw. 1,6 mm. Ferner wurde die topographische Anatomie des Ganges in Relation zur Wirbelsäule untersucht. Bei 54"/o der Patienten lag die Vatersche Papille im mittleren Drittel des zweiten Duodenalsegments.In the following study based on normal endoscopic pancreatograms the length, width, the course of the duct and the topography of the main pancreatic duct were evaluated. MaterialOut of 262 endoscopic pancreatograms 135 did not show any pathological findings. Of these only 48 were suitable for measurements of the entire length of the pancreatic duct documented on a full-size plate. Assessment of the course, topography and of the width was only possible when the duct was photographed in a strict antero-posterior Downloaded by: University ...

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confidence: 63%

Anatomy of the Pancreatic Duct A Duodenoscopic-Radiological Study

Classen¹,

Hellwig²,

Rösch³

1973

Endoscopy

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“…Wiesner et al (90) described that in patients with chronic pancreatitis the changes in the ductal system consisted of irregular wall pattern, changes in size of lumen, multiple stenosis and dilatation, and entire pancreatic duct enlarge ment, and that ERCP was a valuable addition in the diagnosis of chronic pancre atitis, indications for surgery and choice of surgical method for chronic pancre atitis. Braasch et al (8) reported as typical changes of pancreatitis irregularity of the duct outline, dilatation of the duct and distortion of the position of the duct, and also partial obstruction of the common duct in addition to obstruction of the pancreatic duct.…”

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confidence: 99%

Recent Advances in the Endoscopic Retrograde Cholangiopancreatography

Kasugai

1975

Digestion

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Endoscopic retrograde cholangiopancreatography can become a safe and easy procedure by means of sterilization of the instruments. Administration of antibiotics or chemotherapeutic agents, both systemically and mixed with the contrast material, and measurement and control of the injection pressure of the contrast medium using a manometer are employed to achieve as aseptic an operation as possible. For diagnosis of pancreatic cancer in its early stage, as well as diagnosis of minimal and moderate chronic pancreatitis, opacification should extend into not only the main pancreatic duct, but also branches of the pancreatic duct and fine pancreatic ducts. The procedure is one of the most reliable methods for the detection of diseases of pancreatic and biliary systems, especially for the diagnosis of space-occupying lesions such as malignant tumors, and chronic inflammatory changes of the pancreas, as well as differential diagnosis in jaundiced patients.

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