Endosonographic diagnosis of benign pancreatic and biliary lesions.

The transduodenal and transgastric route provides good access to the pancreas and to large parts of the biliary tract, and endosonography (ES) creates images of high-detail resolution. Of 87 patients examined, 33 had benign lesions of the pancreas and biliary tract. All of 12 patients with chronic calcifying pancreatitis were correctly diagnosed, and ES in addition displayed minute cysts that were missed with conventional imaging modalities. Two of three apudomas were seen with ES, and seven of eight common bile duct (CBD) stones could be identified. Adenomyosis of the papilla of Vater was missed in all of three cases. Although minor alterations of the gallbladder can be displayed by ES, benign lesions of this organ are at present not indications for ES, whereas changes in the terminal portion of the CBD are rewarding for ES examination. ES proved to be a useful morphological technique in the diagnosis of minor benign alterations of the pancreas and prepapillary stones.