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KMID : 1038120220550020270
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Clinical Endoscopy
2022 Volume.55 No. 2 p.270 ~ p.278
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Peroral Pancreatoscopy with Videoscopy and Narrow-Band Imaging in Intraductal Papillary Mucinous Neoplasms with Dilatation of the Main Pancreatic Duct
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Kishimoto Yui
Okano Naoki
Ito Ken
Takuma Kensuke
Hara Seiichi
Iwasaki Susumu
Yoshimoto Kensuke
Yamada Yuto
Watanabe Koji
Kimura Yusuke
Nakagawa Hiroki
Igarashi Yoshinori
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Abstract
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Background/Aims: Endoscopic evaluation of intraductal papillary mucinous neoplasms (IPMNs) is useful in determining whether the lesions are benign or malignant. This study aimed to examine the usefulness of peroral pancreatoscopy (POPS) in determining the prognosis of IPMNs.
Methods: POPS with videoscopy was performed using the mother?baby scope technique. After surgery, computed tomography/magnetic resonance cholangiopancreatography or ultrasonography and blood tests were performed every 6 months during the follow-up.
Results: A total of 39 patients with main pancreatic duct (MPD)?type IPMNs underwent POPS using a videoscope, and the protrusions in the MPD were observed in 36 patients. The sensitivity and specificity of cytology/biopsy performed at the time of POPS were 85% and 87.5%, respectively. Of 19 patients who underwent surgery, 18 (95%) patients had negative surgical margins and 1 (5%) patient had a positive margin.
Conclusions: In IPMNs with dilatation of the MPD, POPS is considered effective if the lesions can be directly observed. The diagnosis of benign and malignant lesions is possible depending on the degree of lesion elevation. However, in some cases, slightly elevated lesions may increase in size during the follow-up or multiple lesions may be simultaneously present; therefore, careful follow-up is necessary.
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KEYWORD
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Endoscopic diagnosis, Image-enhanced endoscopy, Intraductal papillary mucinous neoplasm, Peroral video-pancreatoscopy
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