Abstract
Tumors, that occur in the gallbladder, bile ducts and pancreas range from small benign neoplasms in the gallbladder to highly malignant neoplasms of bile ducts and pancreas, which even today are rarely curable. The most common presentation is jaundice.
Laboratory studies generally confirm the presence of biliary obstruction. Ultrasonography is the first examination used for visualization of the biliary tree and pancreas in a jaundiced patient.
An abdominal CT scan usually demonstrates similar findings. In patients with suspected pancreatic cancer the larger mass lesion will almost certainly be demonstrated.
The lower limits of resolution for this method are in the range of 1 to 2 cm. Magnetic resonance cholangiopancreatography (MRCP) is continuing to evolve as a noninvasive imaging technique for the evaluation of both biliary and pancreatic ducts.
ERCP should be performed in all patients with tumors of the bile ducts and pancreas. Endoscopic ultrasonography (EUS) in expert hands is the most valuable method for the determination of preoperative staging.