Endoscopic cytodiagnosis of the pancreas and bile ducts

During the last twelve years we made in 3868 cases cytological investigations of the pancreatic and bile duct systems. The techniques for endoscopic cell collection and microscopic observation are demonstrated. Cellular material consists of epithelia, inflammatory cells and tumor cells. Their cytological details are described. Of primary importance are the differentiations of the epithelial cells in cases of chronic cholangitis and pancreatitis from tumor cells. We found 211 cases with proven malignant tumors of the papilla, the pancreas or the bile ducts. In 81.5% of these cases a significant cellular material could be collected with 59.3% tumor cell diagnoses. No false-positive tumor cell diagnosis was found (n = 3657). A comparison with preoperative bioptic histology was possible only in the papilla region. Here, the sensitivity of histology was 60% compared to 86% sensitivity of cytology. We conclude that the cytodiagnosis of the papilla, the pancreas and the bile duct by means of endoscopic techniques can be done routinely in order to obtain a preoperative diagnosis of inflammatory as well as malignant cellular findings in these organs.