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Peroral pancreatoscopy using the S py G lass system for the assessment of intraductal papillary mucinous neoplasm of the pancreas
Author(s) -
Nagayoshi Yosuke,
Aso Teppei,
Ohtsuka Takao,
Kono Hiroshi,
Ideno Noboru,
Igarashi Hisato,
Takahata Shunichi,
Oda Yoshinao,
Ito Tetsuhide,
Tanaka Masao
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.44
Subject(s) - medicine , intraductal papillary mucinous neoplasm , malignancy , endoscopic retrograde cholangiopancreatography , biopsy , pancreatic duct , radiology , pancreas , adenocarcinoma , gastroenterology , pancreatitis , cancer
Background Peroral pancreatoscopy ( POPS ) using a mother–baby endoscope system is often useful for assessment of intraductal papillary mucinous neoplasm ( IPMN ) of the pancreas with main pancreatic duct ( MPD ) involvement, but is not widely used for several reasons. The aim of this study was to evaluate the usefulness of the S py G lass D irect V isualization S ystem for assessment of IPMN . Methods Seventeen patients diagnosed with possible IPMN with MPD dilation underwent peroral pancreatoscopy using the S py G lass system at our institution. The quality of visualization and the sensitivities of cytological and pathological investigations for diagnosing malignant lesions were evaluated. Results Peroral pancreatoscopy was performed using the S py S cope in 12 patients and an endoscopic retrograde cholangiopancreatography ( ERCP ) catheter in five patients. Sufficient visualization was achieved in 92% of cases using the S py S cope and 40% of cases using the ERCP catheter. Biopsy under direct visualization was successful in seven patients. Biopsy specimens showed adenocarcinoma in one patient, benign neoplastic epithelium in five patients, and regenerative changes in one patient; and had 25% sensitivity and 100% specificity for detecting malignancy. S py G lass pancreatoscopy with irrigation cytology had 100% sensitivity and 100% specificity for detecting malignancy. S py G lass pancreatoscopy was useful for determining the operative excision line in three patients. There were no severe procedure‐related adverse events. Conclusions Peroral pancreatoscopy using the S py G lass system seems to be feasible and useful for assessment of IPMN with a dilated MPD .