The role of ERCP in the era of EUS-FNA for preoperative cytological confirmation of resectable pancreatic ductal adenocarcinoma

Takao Ohtsuka, Koji Tamura, Noboru Ideno, Teppei Aso, Yosuke Nagayoshi, Hiroshi Kono, Junji Ueda, Shunichi Takahata, Akira Aso, Hisato Igarashi, Tetsuhide Ito, Yasuhiro Ushijima, Fumihiko Ookubo, Yoshinao Oda, Kazuhiro Mizumoto, Masao Tanaka

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Purpose: In patients with pancreatic ductal carcinoma (PDAC), EUS-FNA carries a risk of cancer seeding. To avoid this risk, we attempted to obtain preoperative cytological confirmation of adenocarcinoma by ERCP. The aim of this study was to assess the validity of our diagnostic strategy.

Methods: The medical records of 124 consecutive patients who were investigated for potentially resectable PDAC were retrospectively reviewed, and the ability to detect adenocarcinoma by ERCP was evaluated.

Results: ERCP was performed in 115 patients, 69 of whom had positive cytology results. Thirty-four patients underwent EUS-FNA, 29 of whom had positive cytology results. A total of 98 patients (79 %), therefore, had preoperative cytological confirmation of adenocarcinoma, which was more frequent in patients with lesions of the head of the pancreas than in those with lesions of the body or tail of the pancreas. The postoperative pathological diagnosis demonstrated malignant pancreatic neoplasms in 122 patients (98 %), including 111 with PDAC. EUS-FNA did not affect the rate of postoperative peritoneal dissemination.

Conclusions: Our strategy using ERCP as the initial diagnostic modality for obtaining cytological confirmation of potentially resectable PDAC seems to be adequate, yielding a high rate of positive cytology, especially in cases with tumors of the head of the pancreas.

Original languageEnglish
Pages (from-to)1887-1892
Number of pages6
JournalSurgery today
Issue number10
Publication statusPublished - Oct 2014

All Science Journal Classification (ASJC) codes

  • Surgery


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