Significance of peritoneoscopic examination, direct cholangiography and cytological examination of aspirated bile in the diagnosis of biliary and pancreatic malignancies.

The roles played by peritoneoscopic examination, direct cholangiography and cytological examination of aspirated bile at the time of direct cholangiography were studied in 140 patients with various biliary and pancreatic diseases. Both peritoneoscopic and cholangiographic examinations were important in detecting the lesion, and cytological examination was effective in deciding the nature of the lesion. The detection rate of the cancer cells in aspirated bile depended upon the location of aspiration in relation to that of the lesion. The closer the distance the better was the detection rate. The combined use of these three diagnostic methods contributed to correct diagnosis.