
Diagnosis of Bile Duct Strictures
Bile Duct StrictureCholangiocarcinoma2 moreThe purpose of this prospective study is to compare the diagnostic utility of two techniques (brush cytology + FISH and brush cytology + free DNA analysis) in the diagnosis of biliary strictures. Histologic diagnosis (biopsies) in conjunction with clinical and/or imaging follow-up will serve as the gold standard for diagnosis of malignancy. In order to do this the investigators will ask study participants to have a small volume of fluid obtained from the bile duct sent for additional testing at RedPATH. In some patients additional brushings will be obtained for FISH testing (this adds <2 minutes to ERCP and only associated risk is increased procedure duration). The investigators hypothesize that the use of cytology +DNA analysis has a higher sensitivity and accuracy when compared to cytology +FISH in patients with biliary strictures. Primary aim: To compare the sensitivity and accuracy of the two techniques (brush cytology + FISH and brush cytology + free DNA analysis). Histologic diagnosis (histology from biopsy or cytology for fine needle aspiration) in conjunction with clinical and/or imaging follow-up will serve as the gold standard for diagnosis of malignancy. Secondary aims: To evaluate the diagnostic yield of malignancy when all three techniques (cytology, FISH and DNA analysis) are used. To evaluate the added value of biliary forceps biopsies, when used in conjunction with cytology, FISH and DNA analysis.

Endoscopic Ultrasound Elastography in Pancreatic Masses
Pancreatic AdenocarcinomaChronic PancreatitisThe aim of the study is to assess elastography during EUS examinations of focal pancreatic masses, and to consequently differentiate benign versus malignant pancreatic masses in a prospective multi-center design.

Risk Factors for Post-ESWL and Post-ERCP Pancreatitis
Chronic PancreatitisRisk Factors2 moreThe study aimed to identify risk factors for post-ERCP pancreatitis(PEP) after ESWL, and the relationship between the occurrence of post-ESWL pancreatitis and PEP.

Correlation of Chronic Pancreatitis Pathology Features With Endoscopic Ultrasound (EUS) Criteria...
Chronic PancreatitisIn this research project the investigators intend to find out if Endoscopic Ultrasound (EUS) criteria for diagnosing chronic pancreatitis can be correlated with pathologic characteristics of tissues taken from pancreas of patients with suspected chronic pancreatitis. This will be a retrospective study which will examine results from biopsy specimens and endoscopic ultrasound findings in suspected chronic pancreatitis.

CT Pancreas Perfusion
Pancreatic Ductal AdenocarcinomaChronic Pancreatitis1 morePancreatic CT perfusion with a biofeedback breathing belt worn by the participant, and using novel post-processing techniques, is a reliable method which can be used to differentiate between pancreatic cancer, chronic pancreatitis, and autoimmune pancreatitis. Pancreatic CT perfusion can be used to monitor patients undergoing decompression treatment (endoscopic retrograde cholangiopancreatography with stent placement) for painful chronic pancreatitis, and the change in the pancreatic perfusion parameters correlate with the change in the pain parameters (pain scale and analgesic use). Pancreatic CT perfusion parameters can be calculated using surrogate scan data sets at specific time points to replace the continuous scanning.

Determinants of Depression and Its Impact on Quality of Life in Patients With Chronic Pancreatitis...
Chronic PancreatitisDepression2 moreChronic pancreatitis (CP) is associated with recurrent intractable abdominal pain, pancreatic exocrine insufficiency and endocrine dysfunction. Very few studies had evaluated the quality of life in CP, and even a fewer have assessed the mental status in these patients. In the current study, we proposed to evaluate the the relationship between pain, quality of life and depression status in two large independent cohorts of patients with CP. We also proposed to evaluate the brain metabolites in the right and left anterior cingulate cortex, basal ganglia, hippocampus and prefrontal cortex using magnetic resonance spectroscopy. We further proposed to evaluate the pasta metabolites and look for associations with the mental state. Finally, we proposed to evaluate how CP related education of the patients could impact on their mental status and response to interventions on pain.

Pancreatic Duct Evaluation in Autoimmune Pancreatitis: MR Pancreatography
PancreatitisChronic1 moreA prospective intra-individual study to compare the image quality of magnetic resonance (MR) pancreatography at 3.0 T and 1.5 T in patients with autoimmune pancreatitis.

Pancreatic Perfusion Using Secretin and MRI
Chronic PancreatitisThe purpose of this study is to assess pancreatic perfusion in patients with chronic pancreatitis at rest and after secretin stimulation and compare this to published data on pancreatic perfusion in normal subjects.

Role of CXCR2 Ligands/CXCR2 Biological Axis in Pancreatic Cancer
Chronic PancreatitisPancreatic CancerThe investigators hypothesize that the CXCR2 ligands/CXCR2 biological axis plays an important role in promoting angiogenesis in PC; and that the genetic changes and the microenvironment of the tumor regulate the expression of CXCR2 ligands/CXCR2 in PC in order to potentiate their angiogenic phenotype. A corollary of this hypothesis is that the cell surface receptors (CXCR2) and the intracellular signaling pathways that mediate the angiogenic responses induced by ELR+ CXC-chemokines are potential targets for novel therapeutic interventions in PC.

Genetic Linkage Study for Hereditary Pancreatitis
PancreatitisThe purpose of this study is to establish linkage in families with hereditary pancreatitis (HP) to the cationic trypsinogen gene or other, as yet unknown, HP gene(s).