Parasites and Biliary stones

Endoscopic retrograde cholangiopancreatography ١١٧
Advantages of EPBD:
This procedure has the advantage that it preserves the sphincter. Its
effect on the papillary function was studied using endoscopic manometry
before and one week and one month after EPBD.
• One week after EPBD: CBD pressure and sphincter of Oddi peak
pressure and basal pressure were decreased significantly.
• One month after: no serious complications occurred and there was at
least partial recovery of papillary function. So EPBD seems to
preserve the papillary function.
ERCP tissue sampling techniques:
(Sato et al., 1997b)
Aspiration cytology:
Pure bile and pancreatic juice can be sampled by deep cannulation of
the appropriate duct at ERCP. This is obviously a quick and easy way to
obtain specimens, but the results from most studies are relatively
disappointing. In the case of the pancreatic duct, small samples (often less
than 3 mL) are obtained, and it may take up to 20 minutes to collect even
this amount (Lee et al., 1998). Intravenous injection of secretin is helpful
in this regard. For collection of samples from the bile or pancreatic ducts,
it is important to ensure that the specimen is free of iodinated contrast, as
this can cause cellular degeneration and thus false-negatives (Goodale et
al., 1981). For bile cytology, the sensitivity for diagnosis of cancer is low,
ranging from 6% to 32% (Kerr et al., 1991). Aspiration cytology from
the pancreatic duct seems to be more sensitive for cancer detection
(ranging from 33% to 79%) (Del Favero et al., 1988).