Tissue sampling at ERCP in suspected pancreatic cancer.

Endoscopic retrograde cholangiopancreatography (ERCP) is highly sensitive at detecting abnormalities of the pancreas and the biliary tract. Radiographic findings may be highly suggestive of malignancy, but a definitive diagnosis requires examination of cellular material obtained by bile or pure pancreatic juice collection, brushing, fine needle aspiration, or biopsy. This article reviews the general concepts of diagnostic testing and its interpretation, as well as specific results of the various methods used during ERCP to obtain tissue samples.