Digital pancreatoscopy in the evaluation of main duct intraductal papillary mucinous neoplasm: a multicenter study

Endoscopy. 2018 Nov;50(11):1095-1098. doi: 10.1055/a-0596-7374. Epub 2018 Apr 26.

Abstract

Background: The aim of this study was to investigate the outcomes of digital pancreatoscopy in main duct intraductal papillary mucinous neoplasm (MD-IPMN).

Methods: This was a multicenter retrospective study. Outcomes analyzed were safety, incremental pathology yield compared with previous cross-sectional/endoscopic ultrasound (EUS) imaging, and whether the surgical procedure was dictated by the pancreatoscopy.

Results: A total of 31 patients were enrolled from six tertiary care centers. Overall, 42 % of cases had findings on pancreatoscopy that were not seen on cross-sectional imaging or EUS. Digital pancreatoscopy dictated the type of surgery performed in 13 patients (42 %) who underwent surgery. However, in patients with a diffusely dilated pancreatic duct (> 10 mm), the pancreatoscopy dictated the type of surgery in 77 % of cases vs. 17 % of cases in the focally dilated pancreatic duct group (10/13 vs. 3/18; P = 0.001).

Conclusion: Digital pancreatoscopy should be considered in the diagnostic algorithm of MD-IPMN in patients with a diffusely dilated pancreatic duct and without any focal lesions seen on cross-sectional imaging or EUS.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Clinical Decision-Making
  • Dilatation, Pathologic / diagnostic imaging
  • Endoscopy, Digestive System / adverse effects
  • Endoscopy, Digestive System / methods*
  • Endosonography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Ducts / diagnostic imaging*
  • Pancreatic Ducts / pathology
  • Pancreatic Intraductal Neoplasms / diagnostic imaging*
  • Pancreatic Intraductal Neoplasms / surgery
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / surgery
  • Retrospective Studies