Diagnostic Ability of ERCP K. Yamaguchi 1 1Department of Preventive Medicine, Kyoto Prefectural University of Medicine pp.1115-1122
Published Date 1982/10/25
DOI https://doi.org/10.11477/mf.1403108755
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 We discussed diagnostic ability of ERCP for cholangio-pancreatic diseases by studying sensitivity and specificity as major factors as well as true positivity and true negativity as minor factors.

 To simulate sampling groups of each disease, studied materials were selected from 2, 412 cases in which clinical course was able to be followed for more than three years after the ERCP's study. Definite diagnosis of each disease was made by histological diagnosis which was obtained by operation and autopsy, and existence of cholelithiasis or choledocholithiasis was confirmed by operative findings. Exclusion of malignant tumor was made by histological evaluation or more than three year-uneventful prognosis after the ERCP's study.

 Results obtained were as follows  (1) Primary pancreatic cancer: pancreatic cancer was found in 113 out of 1, 223 cases in which the ERCP's study was indicated. Diagnostic ability of the ERCP for pancreatic cancer was found to have its sensitivity, specificity, true positivity and true negativity as 0.94, 0.88, 0.44 and 0.99 respectively. Namely, this test had high ability of picking up pancreatic cancer as well as non pancreatic cancer patients. Especially, negative findings for pancreatic cancer had high reliability but somewhat high trend of false positive was observed.

 (2) Chronic pancreatitis: analyzing 75 cases of chronic pancreatitis in which pancreatic biopsy was performed, we found the ERCP's sensitivity, specificity, true positivity and true negativity for chronic pancreatitis as 0.87, 0.56, 0.67 and 0.80 respectively. These results indicate the ERCP's diagnostic ability for chronic pancreatitis was satisfactory, but it was difficult to rule out false negative cases.

 (3) Choledochal lesions: analyzing operated 246 cases, we found the ERCP's diagnostic sensitivity was 0.94, specificity 0.77, true positivity 0.65, and true negativity 0.96. The ERCP's ability to pick up choledochal lesions was quite high and true negativity was satisfactory. However, we should pay attention for somewhat high false positive findings.

 (4) Gallbladder lesions: analyzing the same cases of 3), we found the ERCP's sensitivity in this lesion was 0.55, specificity 0.80, true positivity 0.93 and true negativity 0.23. The ERCP's ability to pick up gallbladder lesions was low but reliability on normal findings was satisfactory. Reliability on abnormal findings in this lesion was also quite high but this result was mainly due to low rate of visualization of the gallbladder than other diseases.

Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.


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