| Theme |
Management of Cystic Diseases of the Pancreas |
| Title |
Peroral Pancreatoscopy and Intraductal Ultrasonography in the Diagnosis of Intraductal Papillary Mucinous Tumors of the Pancreas |
| Author |
Taketo Yamaguchi |
First Department of Medicine, Chiba University School of Medicine |
| Author |
Taro Hara |
Department of Diagnostic Imaging, Chiba Cancer Center |
| Author |
Takeshi Ishihara |
First Department of Medicine, Chiba University School of Medicine |
| Author |
Hiromitsu Saisho |
First Department of Medicine, Chiba University School of Medicine |
| [ Summary ] |
Recently, peroral pancreatoscopy (POPS) and intraductal ultrasonography (IDUS) have been used as new diagnostic procedures for pancreatic diseases. In this manuscript, we intend to elucidate some useful findings concerning POPS and IDUS for the differential diagnosis of malignant and benign intraductal papillary mucinous tumors of the pancreas (IPMT), and to confirm the significance of these procedures in preoperative examinations. We have performed POPS on 78 and IDUS on 54 with histopathologically confirmed IPMT. Protruding lesions were identified in 55% by using POPS and 71% by using IDUS. Images of fish-egg-like with vascular objects, villous type objects, and vegetative type structures were seen by using POPS. Lesions protruding 5mm or more as seen with IDUS were considered to be malignant. Combined use of POPS and IDUS improved diagnostic accuracy. Tumor progression was successfully evaluated with POPS in about 80% of the cases. Partial resection was performed in 15 (19%) based on the results of POPS and IDUS. The 3-year cumulative survival rate and disease-free survival rate were extremely high at 95% and 93%, respectively. Although further improvement in the design of POPS and IDUS is required, they can be used to differentiate malignant tumors from benign IPMT and may provide useful information for determining the type of surgery to be performed. |