Imaging and staging of bilio-pancreatic tumours: Role of endoscopic and intraductal ultrasonography and guided cytology

Abstract

The promotion and development of endoscopic ultrasonography (EUS) should be pursued and accelerated in specialist centres involved in the management of bilio-pancreatic diseases. In trained hands, and for resectable patients, EUS is the gold standard of the imaging of tumours of the pancreas and extra- hepatic bile ducts, either for diagnostic purposes or loco-regional extension assessment. Thus, it complements ultrasonography, spiral CT or MRI but comes before ERCP which should be avoided as far as possible in resectable patients. The possibility of obtaining histology without risk of seeding with a diagnostic accuracy greater than 90% both for tumours and nodes, constitutes a significant advance in the management of pancreatic tumours.