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Original Articles
- 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
- Clin Endosc 2022;55(2):270-278. Published online December 6, 2021
- DOI: https://doi.org/10.5946/ce.2021.083
- Correction in: Clin Endosc 2023;56(2):261
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Abstract
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PubReader
ePub - 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. -
Citations
Citations to this article as recorded by
- Identification of the course of plastic stent‐induced pancreatic duct mucosal change in chronic pancreatitis using peroral pancreatoscopy (with video)
Kensuke Takuma, Naoki Okano, Yusuke Kimura, Koji Watanabe, Hiroki Nakagawa, Kensuke Hoshi, Masashi Miura, Naobumi Tochigi, Yoshinori Igarashi, Takahisa Matsuda
DEN Open.2025;[Epub] CrossRef - 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
- Identification of the course of plastic stent‐induced pancreatic duct mucosal change in chronic pancreatitis using peroral pancreatoscopy (with video)
- 4,431 View
- 216 Download
- 3 Web of Science
- 4 Crossref
- Predictive Value of Localized Stenosis of the Main Pancreatic Duct for Early Detection of Pancreatic Cancer
- Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Yuki Fujii, Kazuaki Miyamoto, Toji Murabayashi, Fumisato Kozakai, Jun Horaguchi, Yutaka Noda, Masaya Oikawa, Takaho Okada, Kei Ito
- Clin Endosc 2019;52(6):588-597. Published online November 20, 2019
- DOI: https://doi.org/10.5946/ce.2019.018
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Abstract
PDFPubReaderePub
- Background
/Aims: In this study, we aimed to evaluate the predictive value of localized stenosis of the main pancreatic duct (MPD) for early detection of pancreatic cancer.
Methods
Among 689 patients who underwent endoscopic retrograde pancreatography from January 2008 to September 2018, 19 patients with MPD findings were enrolled. These patients showed findings for indicating suspicious pancreatic cancer at an early stage (FiCE); FiCE was defined as a single, localized stenosis in the MPD without a detectable mass (using any other imaging methods) and without other pancreatic diseases, such as definite chronic pancreatitis, intraductal papillary mucinous neoplasm, and autoimmune pancreatitis. Final diagnoses were established by examining resected specimens or through follow-up examinations after an interval of >5 years.
Results
Among 19 patients with FiCE, 11 underwent surgical resection and 8 were evaluated after a >5-year observation period. The final diagnosis of the MPD stenosis was judged to be pancreatic cancer in 9 patients (47%), including 3 with intraepithelial cancer, and to be a non-neoplastic change in 10. The sensitivity, specificity, and accuracy of preoperative pancreatic juice cytology were 75%, 100%, and 88%, respectively.
Conclusions
The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juice cytology is necessary before surgical resection. -
Citations
Citations to this article as recorded by- Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage catheter combined with clinical findings improves diagnostic ability for malignant cases of suspected pancreatic cancer with non-identifiable tumors
Tatsunori Satoh, Junichi Kaneko, Eiji Nakatani, Hirotoshi Ishiwatari, Junya Sato, Akihiko Ohata, Reiko Yamada, Tetsuro Miwata, Kazuma Ishikawa, Fumitaka Niiya, Yosuke Kobayashi, Yasushi Hamaya, Jun Ito, Kazuhito Kawata, Azumi Suzuki, Yasunari Sakamoto, Yu
Pancreatology.2025; 25(1): 125. CrossRef - Efficient Assessment of Tumor Vascular Shutdown by Photodynamic Therapy on Orthotopic Pancreatic Cancer Using High-Speed Wide-Field Waterproof Galvanometer Scanner Photoacoustic Microscopy
Jaeyul Lee, Sangyeob Han, Til Bahadur Thapa Magar, Pallavi Gurung, Junsoo Lee, Daewoon Seong, Sungjo Park, Yong-Wan Kim, Mansik Jeon, Jeehyun Kim
International Journal of Molecular Sciences.2024; 25(6): 3457. CrossRef - Role of endoscopic retrograde cholangiopancreatography in early diagnosis of pancreatic cancer
Yasutaka ISHII, Masahiro SERIKAWA, Shinya NAKAMURA, Juri IKEMOTO, Shiro OKA
Suizo.2024; 39(4): 247. CrossRef - Difference of Risk of Pancreatic Cancer in New-Onset Diabetes and Long-standing Diabetes: A Population-based Cohort Study
Hee Seung Lee, Wonjeong Chae, Min Je Sung, Jiyoung Keum, Jung Hyun Jo, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Eun-Cheol Park, Chung Mo Nam, Sung-In Jang, Seungmin Bang
The Journal of Clinical Endocrinology & Metabolism.2023; 108(6): 1338. CrossRef - Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ
Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clinical Endoscopy.2023; 56(3): 353. CrossRef - Main pancreatic duct stenosis without detecting tumor
Katsuhiko SATO, Minoru SHIGEKAWA, Teppei YOSHIOKA, Shuhei YAMAMOTO, Takayuki MATSUMAE, Kazuhiro KOZUMI, Yu SATO, Jyunya OKABE, Takahiro KODAMA, Hayato HIKITA, Tomohide TATSUMI, Tetsuo TAKEHARA
Suizo.2023; 38(2): 147. CrossRef - Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study
Shinya Nakamura, Yasutaka Ishii, Masahiro Serikawa, Keiji Hanada, Noriaki Eguchi, Tamito Sasaki, Yoshifumi Fujimoto, Atsushi Yamaguchi, Shinichiro Sugiyama, Bunjiro Noma, Michihiro Kamigaki, Tomoyuki Minami, Akihito Okazaki, Masanobu Yukutake, Teruo Mouri
Diagnostics.2023; 13(16): 2696. CrossRef - Endoscopic approach in the diagnosis of high‐grade pancreatic intraepithelial neoplasia
Keiji Hanada, Akihiro Shimizu, Keisuke Kurihara, Morito Ikeda, Takuya Yamamoto, Yasuhiro Okuda, Susumu Tazuma
Digestive Endoscopy.2022; 34(5): 927. CrossRef - Current Screening Strategies for Pancreatic Cancer
Petr Vanek, Ondrej Urban, Vincent Zoundjiekpon, Premysl Falt
Biomedicines.2022; 10(9): 2056. CrossRef - Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma
Ryota Sagami, Kentaro Yamao, Jun Nakahodo, Ryuki Minami, Masakatsu Tsurusaki, Kazunari Murakami, Yuji Amano
Cancers.2021; 13(5): 945. CrossRef - New-Onset or Exacerbation of Diabetes Mellitus Is a Clue to the Early Diagnosis of Pancreatic Cancer
Tetsuya Takikawa, Kazuhiro Kikuta, Kiyoshi Kume, Shin Hamada, Shin Miura, Naoki Yoshida, Seiji Hongo, Yu Tanaka, Ryotaro Matsumoto, Takanori Sano, Mio Ikeda, Masahiro Iseki, Michiaki Unno, Atsushi Masamune
The Tohoku Journal of Experimental Medicine.2020; 252(4): 353. CrossRef - Can Localized Stenosis of the Main Pancreatic Duct be a Predictive Factor for Early Detection of Pancreatic Cancer?
Mamoru Takenaka, Kentaro Yamao, Masatoshi Kudo
Clinical Endoscopy.2019; 52(6): 523. CrossRef
- Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage catheter combined with clinical findings improves diagnostic ability for malignant cases of suspected pancreatic cancer with non-identifiable tumors
- 5,653 View
- 112 Download
- 12 Web of Science
- 12 Crossref
- A Case of a Pancreatic Intraductal Papillary Mucinous Neoplasm Forming Multiple Fistulas and Manifesting as Duodenal Ulcer Bleeding
- Hearn Kook Kim, M.D., Jae Woo Kim, M.D., Myeong Hun Chae, M.D., Jin Hyung Lee, M.D., Hyun Soo Kim, M.D., Soon Koo Baik, M.D., Mee Yon Cho, M.D.* and Seung Whan Cha, M.D.†
- Korean J Gastrointest Endosc 2009;38(4):242-245. Published online April 30, 2009
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Abstract
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- An intraductal papillary mucinous neoplasm (IPMN) of the pancreas is an uncommon tumor characterized by the production of mucin in the pancreatic duct that occasionally involves the formation of fistulas with surrounding organs, including the stomach, duodenum and common bile duct. The mechanism underlying the formation of such fistulas is direct invasion by a tumor or a combination of high pressure in the main pancreatic duct and inflammatory stimulation. A 73-year-old man was referred to our hospital due to the presence of a gastric ulcer detected on screening gastroscopy. Endoscopic findings showed the presence of a whitish thick mucin coated ulcerative lesion that appeared as a perforation or fistula opening. Abdominal computed tomography and magnetic resonance cholangiopancreatography demonstrated the presence of an IPMN of the pancreas and multiple fistula formation with the neighboring organs. An endoscopic biopsy was carried out to obtain pancreatic tumor tissue through the pancreatogastric fistula and the mass was confirmed as a mucinous adenocarcinoma. To the best of our knowledge, this is the first case of an IPMN associated with a pancreatojejunal fistula and duodenal ulcer bleeding due to fistula formation. (Korean J Gastrointest Endosc 2009;38:242-246)
- 2,173 View
- 6 Download
- A Case of Pancreatogastric Fistula Associated with Intraductal Papillary Mucinous Neoplasm
- Seung Geun Lee, M.D., Il Du Kim, M.D., Hye Jeong Lee, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D., Jee Yeon Kim, M.D.* and Suk Kim, M.D.†
- Korean J Gastrointest Endosc 2006;33(4):257-260. Published online October 30, 2006
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Abstract
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- There have been an increasing number of reports of intraductal papillary mucinous neoplasm (IPMN) of the pancreas since its first report by Ohhasi et al. in 1982. However, fistula formation associated with IPMN to other organs is rare. A 79-year -old woman visited our hospital due to diarrhea and dyspepsia for 3 months. Abdominal computed tomography and magnetic resonance imaging revealed IPMN of the pancreas and fistula formation in the stomach. Endoscopic retrograde cholangiography after injecting a dye through the pancreatic duct showed dye flowing out into stomach. An endoscopic biopsy was carried out through the pancreatogastric fistula and this tumor was confirmed to be IPMN. We report a case of pancreatogastric fistula associated with IPMN that was confirmed by histology. (Korean J Gastrointest Endosc 2006;33:257261)
- 2,107 View
- 18 Download
- Intraductal Papillary Mucinous Neoplasm in a Patient with an Incomplete Pancreatic Divisum
- Sung-Min Nam, M.D., Woo-Chul Chung, M.D., Hyung-Min Chin, M.D.*, Kang-Moon Lee, M.D., Bo-In Lee, M.D., U-Im Chang, M.D., Jin-Mo Yang, M.D., Kyu-Yong Choi, M.D. and In-Sik Chung, M.D.
- Korean J Gastrointest Endosc 2006;33(3):191-195. Published online September 30, 2006
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Abstract
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- Intraductal papillary mucinous neoplasms (IPMNs) are premalignant lesions that require a surgical resection. IPMN can cause abdominal pain or pancreatitis as a result of either mucin production or a papillary growth, resulting in a ductal obstruction. Most IPMNs arise from the main pancreatic duct. However, IPMNs arising from the accessory pancreatic duct are extremely rare. Pancreatic divisum occurs when the ventral and dorsal ducts of the pancreas fail to fuse during organogenesis. It is the most common congenital variant of pancreatic-ductal development, and occurs in approximately 10∼14% of individuals. Although pancreatic divisum has no clinical relevance, some patients present with acute recurrent or chronic pancreatitis. In most cases, it is discovered incidentally during an examination of pancreatitis, and is occasionally accompanied by a pancreatic tumor. We report the first case of IPMN in a patient with an incomplete pancreatic divisum in Korea. (Korean J Gastrointest Endosc 2006;33:191196)
- 2,775 View
- 15 Download
- Intraductal Papillary Mucinous Neoplasm of the Pancreas: The Role of Intraductal Ultrasonography in Selection of Resection Method of Pancreas
- Seung Hoon Baek, M.D., Young Deok Cho, M.D., Jae Young Jang, M.D., Young Koog Cheon, M.D., Young Seok Kim, M.D., Jong Ho Moon, M.D., Yun Soo Kim, M.D., Moon Sung Lee, M.D., Kyung Yul Hur, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.
- Korean J Gastrointest Endosc 2005;31(2):90-96. Published online August 30, 2005
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Abstract
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- Background
/Aims: The treatment of choice of intraductal papillary mucinous neoplasm (IPMN) is partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMN. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting the extension of IPMN and selecting the resection methods of pancreas. Methods: A preoperative assessment of IPMN by IDUS was performed in 12 patients who underwent a surgical resection of IPMN. According to the preoperative localization of IPMN by IDUS, various types of limited pancreatic resections were planned. The histologic examination of the frozen section of the pancreatic cut surface was performed in all patient. In the cases of tumor involvement as cut surface margin, a modification of the planned pancreatic resection was done. Results: Technical success was achieved in all 12 cases (100%). There were positive tumor margin of cut surfaces in 2 patients. Of 10 cases whose frozen tissue evaluation of the pancreatic cut surface had been negative at first, one patieat has turned out to be margin positive in permanent section examination, finally. Overall accuracy of IDUS in predicting the continuous extension of IPMN was 75%. Conclusions: IDUS is a reliable diagnostic modality to guide the resection extent of the pancreas in patients with IPMN. (Korean J Gastrointest Endosc 2005;31:9096)
- 1,876 View
- 5 Download
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