Initial experience of peroral pancreatoscopy combined with narrow-band imaging in the diagnosis of intraductal papillary mucinous neoplasms of the pancreas (with videos).
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.
Itoi
Takao
T
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Sofuni
Atsushi
A
Itokawa
Fumihide
F
Kurihara
Toshio
T
Tsuchiya
Takayoshi
T
Ishii
Kentaro
K
Tsuji
Shujiro
S
Ikeuchi
Nobuhito
N
Arisaka
Yoshifumi
Y
Moriyasu
Fuminori
F
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