Efficacy of peroral pancreatoscopy in the diagnosis of pancreatic diseases.
BACKGROUND
The aim of this study was to evaluate the usefulness of peroral pancreatoscopy in the diagnosis of pancreatic diseases.


METHODS
Both 3.7-mm (thin) and 0.8-mm (ultra-thin) diameter fiberoptic pancreatoscopes were used in 115 cases (pancreatic cancer, 35; benign ductal stenosis, 20; intraductal papillary-mucinous tumor, 60).


RESULTS
Observation rates for pancreatic cancer, benign ductal stenosis, and intraductal papillary-mucinous tumor were, respectively, 63%, 80%, and 95%. Tumor vessels and papillary tumor were observed when pancreatic cancer was smaller than 2 cm but not when the tumor was larger than 2 cm. Stenosis without significant mucosal changes was observed in 62% of cases of benign ductal stenosis. Coarse mucosa and friability were observed more frequently in association with pancreatic cancer than benign ductal stenosis. Granular mucosa or papillary tumor could be observed in 74% of cases of intraductal papillary-mucinous tumor. Papillary tumor was observed with increasing frequency in cases of intraductal papillary-mucinous tumor as the degree of malignancy increased.


CONCLUSIONS
Peroral pancreatoscopy with an ultra-thin fiberscope is useful in the diagnosis of minute pancreatic lesions. Peroral pancreatoscopy with a thin fiberscope can provide a definitive diagnosis of intraductal papillary-mucinous tumor including the degree of malignancy.
Yamao
Kenji
K
Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
Ohashi
Kazuhiko
K
Nakamura
Tsuneya
T
Suzuki
Takashi
T
Sawaki
Akira
A
Hara
Kazuo
K
Fukutomi
Akira
A
Baba
Toshiaki
T
Okubo
Kenji
K
Tanaka
Kyosuke
K
Moriyama
Ichiro
I
Fukuda
Kosuke
K
Matsumoto
Kakuya
K
Shimizu
Yasuhiro
Y
D000328:Adult; D001707:Biopsy, Needle; D015331:Cohort Studies; D003937:Diagnosis, Differential; D019723:Endoscopes; D016145:Endoscopy, Digestive System / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009055:Mouth; D009092:Mucous Membrane / Q000473:pathology; D009367:Neoplasm Staging; D010182:Pancreatic Diseases / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D012680:Sensitivity and Specificity