| Theme |
The Current State of Management of Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas |
| Title |
Utility of EUS for the Management of IPMN |
| Author |
Ken Kamata |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Masayuki Kitano |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Masatoshi Kudo |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Kentaro Yamao |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Hajime Imai |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Hiroki Sakamoto |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| [ Summary ] |
In the management of intraductal papillary mucinous neoplasm (IPMN), it is very important to distinguish IPMNs from other cystic lesions of the pancreas at the initial diagnosis in order to guide patient management. The patient diagnosed with IPMN is selected for resection or follow-up based on the malignant potential of the lesion. For the differential diagnosis of pancreatic cystic lesions, it is important and useful to evaluate the internal structure, the presence of mural nodules, and communication with main pancreatic duct using endoscopic ultrasound (EUS). For evaluating the malignant potential of IPMN, detecting mural nodules by EUS is also useful. Moreover, contrast-enhanced harmonic EUS helps avoid misinterpretation in cases that have many mucus clots and sludge in the cystic lesions. During surveillance of branch-duct IPMN, screening of the whole pancreas is necessary to check for the presence of IPMN-concomitant pancreatic cancer, as well as for IPMN-derived pancreatic cancer. In this context, EUS plays a fundamental role. |