title: Current roles of endoscopy in the management of intraductal papillary mucinous neoplasm of the pancreas.
abstract: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to its histomorphological and immunohistochemical characteristics. Endoscopic retrograde cholangiopancreatography plays a crucial role in the evaluation of these features of IPMN. Endoscopic ultrasonography (EUS) has proven to be more sensitive than computed tomography or magnetic resonance imaging for early detection of malignancy. The present review addresses the current roles of endoscopy and related techniques in the management of IPMN. The particular focus is on diagnosing IPMN and malignancy within IPMN, detecting pancreatic cancer concomitant with IPMN, differentiating the epithelial subtypes of IPMN, determining the optimal strategy for the management of branch duct IPMN, and discussing innovative endoscopic technology related to IPMN. The disadvantages of endoscopic examinations of IPMN and different attitudes toward EUS-guided fine-needle aspiration for IPMN between Japan (negative) and other countries (active) are also discussed.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery
keywords: endoscopic retrograde cholangiopancreatography; endoscopic ultrasonography; epithelial subtype; intraductal papillary mucinous neoplasm; pancreatic cancer