title: Initial experience of peroral pancreatoscopy combined with narrow-band imaging in the diagnosis of intraductal papillary mucinous neoplasms of the pancreas (with videos).
abstract: BACKGROUND
  It is very important to determine the extent of intraductal mucinous neoplasms (IPMNs), because this can greatly affect the determination of the indications of surgery. Peroral pancreatovideoscopy (POPS) has been recognized as a new diagnostic tool for clear imaging of IPMN. Recently, narrow-band imaging (NBI) has made it possible to emphasize certain image features, such as mucosal structures and capillary vessels.
  
  
  OBJECTIVE
  To evaluate the clinical usefulness of POPS by using NBI for the diagnosis of IPMN.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  This procedure was performed at Tokyo Medical University Hospital.
  
  
  METHODS
  Three patients with IPMN.
  
  
  METHODS
  All patients underwent POPS with NBI.
  
  
  METHODS
  Efficacy and safety of this technique.
  
  
  RESULTS
  POPS with NBI was performed in 3 patients, without procedure-related complications. Identification of the surface structure and the capillary vessels by NBI observation was better than by conventional observation. Furthermore, NBI identified skip tumor lesions in the tail of pancreas, which were not detected by conventional POPS.
  
  
  CONCLUSIONS
  Because none of the patients in the 3 cases underwent surgical resection, a comparison to clarify total agreement between the preoperative POPS findings and the resected specimen was not possible.
  
  
  CONCLUSIONS
  POPS with NBI may facilitate the observation of both fine mucosal structures and capillary vessels in patients with IPMN, although further study is necessary to fully establish the clinical benefit.
authors: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors: Takao
authors: T
authors: Itoi
authors: Atsushi
authors: A
authors: Sofuni
authors: Fumihide
authors: F
authors: Itokawa
authors: Toshio
authors: T
authors: Kurihara
authors: Takayoshi
authors: T
authors: Tsuchiya
authors: Kentaro
authors: K
authors: Ishii
authors: Shujiro
authors: S
authors: Tsuji
authors: Nobuhito
authors: N
authors: Ikeuchi
authors: Yoshifumi
authors: Y
authors: Arisaka
authors: Fuminori
authors: F
authors: Moriyasu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D002291:Carcinoma, Papillary / Q000175:diagnosis*; D003937:Diagnosis, Differential; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies