Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Peroral Pancreatoscopy with Videoscopy and Narrow-Band Imaging in Intraductal Papillary Mucinous Neoplasms with Dilatation of the Main Pancreatic Duct

  • Yui Kishimoto (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Naoki Okano (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Ken Ito (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Kensuke Takuma (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Seiichi Hara (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Susumu Iwasaki (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Kensuke Yoshimoto (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Yuto Yamada (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Koji Watanabe (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Yusuke Kimura (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Hiroki Nakagawa (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center) ;
  • Yoshinori Igarashi (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center)
  • Received : 2021.02.14
  • Accepted : 2021.07.27
  • Published : 2022.03.30
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Abstract

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.

Keywords

Acknowledgement

We thank the Department of Gastroenterology and Hepatology for their cooperation in conducting this study. We also thank the staff of the endoscopy and radiation departments for performing peroral pancreatoscopy. We would also like to express our gratitude to the professors at the Department of Surgical Pathology, Omori Hospital, for their help with tissue diagnosis and cytology.

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