The value of operative pancreatography.

Between 1978 and 1982 operative pancreatography was undertaken in 39 patients (mean age 47 years) using 1 of 4 different techniques. Final diagnoses were chronic pancreatitis (15), isolated dorsal pancreas (10), carcinoma head of pancreas (3), acute pancreatitis (3) and miscellaneous pancreatic conditions (8). Retrograde (transduodenal) pancreatograms were successfully obtained in 10 of 12 patients, including 3 via the minor papilla. Prograde cannulation was achieved after distal pancreatectomy in 15 of 16 patients, 10 of whom had an isolated dorsal pancreas. 'Ambigrade' pancreatography was performed after direct puncture of a palpable duct in 6 patients and cystography in another 5 patients with pseudocysts. No complications of pancreatography were seen and the radiological findings modified the operative procedure in 16 patients (41 per cent).