Inclusion Criteria:  Inpatients and outpatients 18 years of age or older with solid mass lesions in the pancreas or extrahepatic biliary system  Exclusion Criteria:  Uncorrectable coagulopathy (INR > 1.5) Uncorrectable thrombocytopenia (platelet < 50,000) Decline to participate in the study and sign the informed consent form Cystic lesions.