title: Electronic pancreatoscopy for the diagnosis of pancreatic diseases.
abstract: OBJECTIVE
  Diagnostic pancreatoscopy was performed in 56 patients using the newly developed peroral electronic pancreatoscope (PEPS). The diagnostic value of the PEPS for pancreatic diseases was evaluated.
  
  
  METHODS
  The PEPS (external diameter = 2.1 mm, bidirectional tip deflection) was developed with a minute 50,000-pixel interline charge-coupled device. Pancreatoscopy was performed by means of an endoscopic retrograde approach without sphincterotomy. The cases examined were normal (three), chronic pancreatitis (32), pancreatic cancer (eight), and intraductal papillary mucinous tumors (13).
  
  
  RESULTS
  Of the 56 cases, 42 (75%) were adequately seen. In normal cases, fine capillary vessels were clearly visualized on the smooth whitish-pink mucosa. Findings in chronic pancreatitis included protein plugs, calcified stones, rough whitish mucosa, scar formation, edema, erythema, and indistinct capillary appearance. All the stenoses of chronic pancreatitis could be differentiated from those of pancreatic cancer with the PEPS. In the pancreatic cancer cases, all patients had stenoses or duct cutoffs; most cases had friable mucosa with erythema and erosive changes, and a single patient had a compressed pancreatic duct wall covered with normal epithelium. In the cases of intraductal papillary mucinous tumors, papillary tumors were visualized with extreme clarity. In the case of adenocarcinoma, the PEPS revealed oval-shaped tumors with spotty redness or villous tumors with dilation of capillary vessels. Moderate acute pancreatitis was recognized after pancreatoscopy in one of the 56 cases (1.8%).
  
  
  CONCLUSIONS
  Electronic pancreatoscopy with the PEPS is feasible in most patients and technically safe, and improves diagnostic yield over conventional pancreatoscopy.
authors.affiliation: Department of Gastroenterology, Otsu Municipal Hospital, Shiga, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kodama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Koshitani
authors.forename: Hideki
authors.initials: H
authors.lastname: Sato
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Keimei
authors.initials: K
authors.lastname: Kato
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Abe
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakabayashi
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Tatsumi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Horii
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yamane
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
mesh_terms: D004582:Electronics, Medical / Q000295:instrumentation* / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000473:pathology*; D012680:Sensitivity and Specificity