| Theme | IPMN/Pancreatic Cyst as an Increasing Common Disease -- Current Status and Issues | |
|---|---|---|
| Title | Diagnosis of Malignancy by Using ERCP in Patients with IPMNs | |
| Publish Date | 2019/11 | |
| Author | Shinsuke Koshita | Department of Gastroenterology, Sendai City Medical Center |
| Author | Yoshihide Kanno | Department of Gastroenterology, Sendai City Medical Center |
| Author | Takahisa Ogawa | Department of Gastroenterology, Sendai City Medical Center |
| Author | Kaori Masu | Department of Gastroenterology, Sendai City Medical Center |
| Author | Yutaka Noda | Department of Gastroenterology, Sendai City Medical Center |
| Author | Kei Ito | Department of Gastroenterology, Sendai City Medical Center |
| [ Summary ] | The aims of diagnostic ERCP for patients with IPMNs are the following: 1）a diagnosis of IPMN itself, 2）an evaluation of whether the main pancreatic duct is involved or not, and 3）pancreatic juice/tissue acquisition for the diagnosis of malignancy. In Japan, pancreatic juice/tissue acquisition for the diagnosis of malignant IPMN has been performed through ERCP. Regarding several reports by Japanese researchers, some devices, such as brush cytology, lavage pancreatic duct cytology, pancreatoscopy‒guided pancreatic juice/tissue acquisition, and the administration of secretin, are being applied for improving sensitivity of ERCP‒based cytology/histology to detect malignancy. Since 2005, we have performed the cell block method for evaluating pancreatic juice cytology to determine malignant branch duct type IPMN and reported excellent results in the detection of malignancy (sensitivity, 79 %; specificity, 100 %). In addition, we reported the possibility that pancreatic juice/tissue acquisition can contribute to more accurate diagnosis of malignant main duct type IPMNs. | |