Preoperative Percutaneous Pancreatography Under Real-Time Sonographic Guidance

✍ Scribed by Lawrence G. Manco; Welland F. Short

• Publisher: John Wiley and Sons
• Year: 1984
• Tongue: English
• Weight: 525 KB
• Volume: 12
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870120713

✦ Synopsis

Although medical therapy for chronic pancreatitis may alleviate some symptoms due to endocrine and exocrine dysfunction, many patients develop severe debilitating chronic abdominal pain. Uncontrollable, incapacitating abdominal pain is a common indication for surgical intervention. 'I2 Careful preoperative pancreatic and biliary duct evaluation is essential for proper patient and surgical procedure ~election."~ Although endoscopic retrograde cholangiopancreatography (ERCP) is the procedure of choice for evaluation of pancreatic and biliary ductal it may be unsuccessful or nondiagnostic."

This report describes two patients who presented with chronic relapsing pancreatitis and incapacitating abdominal pain in whom preoperative ERCP was unsuccessful. Under real-time sonographic guidance, percutaneous pancreatography was successfully performed without incident, accurately defining the pancreatic duct anatomy and demonstrating several common complications of chronic pancreatitis. The indications, technique, and potential complications of this under-utilized procedure are discussed.

PROCEDURE

All sonographic examinations were performed in real-time using the Technicare Auto Sector digital unit. Freeze-frame images were recorded on radiographic film. The pancreas and pancreatic duct were examined using scanning techniques previously described."-12 Care was taken to en-From the Department of Medical Imaging, Memorial Hospital, Albany, NY. Manuscript