| Theme | IPMT ; Intraductal Papillary-Mucinous Tumor | |
|---|---|---|
| Title | Diagnosis of Intraductal Papillary Mucinous Tumor of the Pancreas by Balloon-Catheter ERP-Compression Study (Balloon ERP-CS) | |
| Publish Date | 2006/02 | |
| Author | Seiyo Ikeda | First Department of Surgery, Fukuoka University School of Medicine |
| Author | Shinichiro Ryu | First Department of Surgery, Fukuoka University School of Medicine |
| Author | Kenji Ogata | First Department of Surgery, Fukuoka University School of Medicine |
| Author | Kensei Maeshiro | First Department of Surgery, Fukuoka University School of Medicine |
| Author | Yohichi Yasunami | First Department of Surgery, Fukuoka University School of Medicine |
| Author | Yoshihiro Hamada | Department of Pathology, Fukuoka University School of Medicine |
| Author | Yoshifuku Nakayama | Department of Pathology, Fukuoka University School of Medicine |
| [ Summary ] | IPMT arises from the pancreatic ductal epithelium ; therefore, it is important to precisely show the wall of the duct. However, conventional ERP is frequently insufficient because of mucus retention and enlargement of the papilla Vateri orifice. Balloon ERP-CS can overcome these limitations and can allow excellent visualization of the pancreatic duct. In cases with a copious amount of mucus retention, mucus aspiration with a large bore catheter before performing balloon ERP-CS can eradicate the effect of mucus retention. Ductal dilatation of IPMT can be classified into three types based on balloon ERP-CS findings. In cases of Branch Duct A type without dilatation of the main duct, even balloon ERP-CS is somewhat limited in visualizing the cystic lesions. While in most cases of Branch Duct B type with the main duct of more than a 5 mm dilation, the multilocular cyst is well visualized by the balloon ERP-CS. Thus, the pancreatograms can also be used for follow-up observation of the cystic tumors. In Main Duct type cases with a highly dilated main pancreatic duct, balloon ERP-CS can precisely determine the presence of an elevated lesion inside the duct, which is one of our chief pancreatographic criteria for malignancy. EUS is very useful in differentiating mucus from polypoid tumors and diagnosing the presence of invasion. |
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