| Theme |
Progress in Endoscopic Ultrasonography for Biliopancreatic Diseases |
| Title |
Role of EUS for Diagnosing the Pancreatic Diseases |
| Author |
Mitsuhiro Kida |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Takaaki Matsumoto |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Kazuho Uehara |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Yusuke Kawaguchi |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Rikiya Hasegawa |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Eiji Miyata |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Toru Kaneko |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Hiroshi Yamauchi |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Kosuke Okuwaki |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Shiro Miyazawa |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Tomohisa Iwai |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Hidehiko Kikuchi |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Hiroshi Imaizumi |
Department of Gastroenterology, Kitasato University School of Medicine |
| Author |
Wasaburo Koizumi |
Department of Gastroenterology, Kitasato University School of Medicine |
| [ Summary ] |
Endoscopic ultrasound (EUS) has an important role in pancreatic diseases for : 1) diagnosis of pancreatic tumors ; 2) local staging of pancreatic tumors ; 3) diagnosis of mural nodules in patients having intraductal papillary mucinous neoplasms (IPMN) ; 4) visualization of mural nodule and septum of mucinous cystic neoplasm (MCN), furthermore contents of MCN is detected as fluid with high echo foci, 5) serous cystic neoplasms (SCN) are visualized as a cluster of cystic components. It is important to detect small pancreatic cancer at an early stage, because the 5‒year survival rate of patients with pancreatic cancer is only 7 %, and its incidence is nearly equal to its mortality. EUS is also useful to follow up patients having IPMN after a diagnosis of mural nodules and concomitant pancreatic cancer has been confirmed. Additionally, EUS helps to differentiate between pancreatic neuroendocrine tumors (P‒NET) and pancreatic cancer, especially with use of contrast media.
Thus, it is important to diagnose "early stage pancreatic cancer" to improve its survival rate. Therefore, periodic follow up examination of patients with risk factors such as family history of pancreatic cancer, hereditary pancreatic cancer syndrome, diabetes mellitus, chronic pancreatitis, IPMN, obesity, among others is imperative. Furthermore, patients with epigastralgia, dilatation of pancreatic ducts, pancreatic cysts, and other such conditions, should be examined using EUS, computed tomography (CT), and magnetic resonance cholangiopancreatography (MRCP). Although histological diagnosis appears to be an ideal approach to diagnose pancreatic cancer, endoscopic retrograde cholangiopancreatography (ERCP) carries the risk of pancreatitis, as does an endoscopic ultrasound‒guided fine needle aspiration biopsy (EUS‒FNA), which predisposes the patient to some risk of seeding. These procedures should be performed only after obtaining informed consent from patients. |