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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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Yui Kishimoto, Naoki Okano, Ken Ito, Kensuke Takuma, Seiichi Hara, Susumu Iwasaki, Kensuke Yoshimoto, Yuto Yamada, Koji Watanabe, Yusuke Kimura, Hiroki Nakagawa, Yoshinori Igarashi
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Clin Endosc 2023;56(2):261-261. Published online March 6, 2023
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DOI: https://doi.org/10.5946/ce.2021.083.e1
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Corrects: Clin Endosc 2022;55(2):270
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PDFPubReaderePub
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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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Yui Kishimoto, Naoki Okano, Ken Ito, Kensuke Takuma, Seiichi Hara, Susumu Iwasaki, Kensuke Yoshimoto, Yuto Yamada, Koji Watanabe, Yusuke Kimura, Hiroki Nakagawa, Yoshinori Igarashi
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Clin Endosc 2022;55(2):270-278. Published online December 6, 2021
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DOI: https://doi.org/10.5946/ce.2021.083
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Correction in: Clin Endosc 2023;56(2):261
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Abstract
PDFPubReaderePub
- 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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Citations
Citations to this article as recorded by
- Pancreatoscopy-Guided Endotherapies for Pancreatic Diseases
Yuri Hanada, Raj J. Shah Gastrointestinal Endoscopy Clinics of North America.2024; 34(3): 417. CrossRef - Peroral pancreatoscopy with videoscopy and narrow-band imaging in intraductal papillary mucinous neoplasms with dilatation of the main pancreatic duct
Yui Kishimoto, Naoki Okano, Ken Ito, Kensuke Takuma, Seiichi Hara, Susumu Iwasaki, Kensuke Yoshimoto, Yuto Yamada, Koji Watanabe, Yusuke Kimura, Hiroki Nakagawa, Yoshinori Igarashi Clinical Endoscopy.2023; 56(2): 261. CrossRef - Predicting Malignancy by Peroral Pancreatoscopy of an Intraductal Papillary Mucinous Neoplasm with a Dilated Main Pancreatic Duct: Is Seeing Enough?
Yun Nah Lee, Jong Ho Moon Clinical Endoscopy.2022; 55(2): 213. CrossRef
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Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors
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Naoki Okano, Yoshinori Igarashi, Ken Ito, Saori Mizutani, Hiroki Nakagawa, Kouji Watanabe, Yuuto Yamada, Kensuke Yoshimoto, Yuusuke Kimura, Susumu Iwasaki, Kensuke Takuma, Seiichi Hara, Yuui Kishimoto
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Clin Endosc 2021;54(5):706-712. Published online March 10, 2021
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DOI: https://doi.org/10.5946/ce.2020.208
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Abstract
PDFPubReaderePub
- Background
/Aims: Bleeding is a complication of endoscopic snare papillectomy for ampullary tumors. This study aimed to investigate the clinical efficacy of hypertonic saline-epinephrine (HSE) local injection before endoscopic papillectomy for prevention of bleeding.
Methods We retrospectively reviewed the data of 107 consecutive patients with ampullary tumors who underwent endoscopic papillectomy. The rates of en bloc resection, pathological resection margins, and prevention of immediate or delayed bleeding in the simple snaring resection group (Group A) and the HSE injection group (Group B) were compared.
Results A total of 44 and 63 patients were enrolled in Groups A and B, respectively. The total complete resection rate was 89.7% (96/107); the clinical complete resection rates in Group A and Group B were 86.3% (38/44) and 92.1% (58/63), respectively (p=0.354). Post-papillectomy bleeding occurred in 22 patients. In Groups A and B, the immediate bleeding rates were 20.5% (9/44) and 4.8% (3/63), respectively (p=0.0255), while the delayed bleeding rates were 7% (3/44) and 11% (7/63), respectively (p=0.52). The rates of positive horizontal and vertical pathological margin in both groups were 27% and 16%, respectively.
Conclusions HSE local injection was effective in preventing immediate bleeding and was useful for safely performing endoscopic papillectomy for ampullary tumors.
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- Endoscopic papillectomy for ampullary lesions of minor papilla
Kien Vu Trung, Christian Heise, Einas Abou-Ali, Francesco Auriemma, Elias Karam, Sophia E. van der Wiel, Marco J. Bruno, Fabrice Caillol, Marc Giovannini, Viliam Masaryk, Uwe Will, Andrea Anderloni, Enrique Pérez-Cuadrado-Robles, Ana Dugic, Benjamin Meier Gastrointestinal Endoscopy.2024; 99(4): 587. CrossRef - Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: a propensity score-matched cohort
Kien Vu Trung, Einas Abou-Ali, Fabrice Caillol, Woo H. Paik, Bertrand Napoleon, Viliam Masaryk, Sophia E. van der Wiel, Enrique Pérez-Cuadrado-Robles, Nicolas Musquer, Asif Halimi, Kevin Soares, Francois R. Souche, Steffen Seyfried, Maria C. Petrone, Stef Endoscopy.2023; 55(08): 709. CrossRef - Updates in endoscopic management of ampullary and duodenal adenomas
Pravallika Chadalavada, Tilak Upendra Shah Current Opinion in Gastroenterology.2023; 39(6): 496. CrossRef - Submucosal Epinephrine Injection Before Endoscopic Papillectomy: Less is More?
Roy L.J. van Wanrooij, Jeanin E. van Hooft Clinical Endoscopy.2021; 54(5): 627. CrossRef
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Endosonographic Preoperative Evaluation for Tumors of the Ampulla of Vater Using Endoscopic Ultrasonography and Intraductal Ultrasonography
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Naoki Okano, Yoshinori Igarashi, Seiichi Hara, Kensuke Takuma, Itaru Kamata, Yui Kishimoto, Takahiko Mimura, Ken Ito, Yasukiyo Sumino
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Clin Endosc 2014;47(2):174-177. Published online March 31, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.2.174
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Abstract
PDFPubReaderePub
- Background/Aims
In recent years, endoscopic snare papillectomy has been performed to treat tumors of the ampulla of Vater. This procedure requires accurate preoperative evaluation. In this study, we diagnosed the focal extension of such tumors by using endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS), and examined the indications for endoscopic snare papillectomy. MethodsThe subjects were 48 patients with a papillary tumor (13 patients, surgical resection; 35 patients, endoscopic snare papillectomy) who were evaluated preoperatively with EUS and IDUS. The tumor-node-metastasis classification was used for the endosonographic evaluation and pathological diagnosis of these tumors. ResultsThe diagnostic accuracy of EUS was 97% for diagnosing adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 50% for pT3-4 tumors, for an overall accuracy of 85% for T-staging. The diagnostic accuracy of IDUS was 94% for adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 100% for pT3-4 tumors, for an overall accuracy of 80% for T-staging. ConclusionsEUS and IDUS are highly capable of evaluating tumors of the ampulla of Vater preoperatively. However, these techniques are not sufficient for evaluating the focal extension of carcinomas preoperatively. Currently, endoscopic snare papillectomy is adequate for treating adenomas and pTis tumors.
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Takao Itoi, Shomei Ryozawa, Akio Katanuma, Hiroki Kawashima, Eisuke Iwasaki, Shinichi Hashimoto, Kenjiro Yamamoto, Toshiharu Ueki, Yoshinori Igarashi, Kazuo Inui, Naotaka Fujita, Kazuma Fujimoto Digestive Endoscopy.2022; 34(3): 394. CrossRef - Diagnostic accuracy of endoscopic ultrasound and intraductal ultrasonography for assessment of ampullary tumors: a meta-analysis
Xiaohua Ye, Lei Wang, Zhendong Jin Scandinavian Journal of Gastroenterology.2022; 57(10): 1158. CrossRef - The Long-Term Outcomes of Endoscopic Papillectomy and Management of Cases of Incomplete Resection: A Single-Center Study
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Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Tadashi Iida, Hiroyuki Tanaka, Kazuhiro Furukawa, Masanao Nakamura, Takashi Honda, Senju Hashimoto, Akihiro Itoh, Masatoshi Ishigami, Yoshiki Hirooka, Mitsuhiro Fujishiro Digestive Endoscopy.2021; 33(5): 858. CrossRef - Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
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