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Single-operator pancreatoscopy is helpful in the evaluation of suspected intraductal papillary mucinous neoplasms (IPMN)
Vise andre og tillknytning
2014 (engelsk)Inngår i: Pancreatology (Print), ISSN 1424-3903, E-ISSN 1424-3911, Vol. 14, nr 6, s. 510-514Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND AND OBJECTIVE: Even when advanced cross-sectional imaging modalities have been employed, endoscopic evaluation of intraductal papillary mucinous neoplasms (IPMN) is often required in order to assess the final character and extent of lesions. The current study addresses the use of SpyGlass single-operator peroral pancreatoscopy in suspected IPMN.

DESIGN: A prospective, non-randomized exploratory cohort study.

SETTING: Single-center.

PATIENTS AND INTERVENTION: A prospective study-cohort of 44 consecutive patients in a single tertiary referral center who underwent ERCP and peroral pancreatoscopy, was prospectively collected between July 2007 and March 2013 because of a radiological signs of IPMN. These IPMN-findings were discovered incidentally in 44% of the cases.

MAIN OUTCOME MEASUREMENTS: Diagnostic accuracy (specificity & sensitivity) and complications.

RESULTS: The targeted region of the pancreatic duct was reached with the SpyGlass system in 41 patients (median age 65 years, 41% female). Three patients were excluded from analysis because of failed deep cannulation of the pancreatic duct. Brush cytology was taken in 88% and direct biopsies in 41%. IPMN with intermediate or high-grade dysplasia was the main final diagnosis (76%) in 22 patients who had surgery. Out of the 17 patients with a final diagnosis of MD-IPMN, 76% were correctly identified by pancreatoscopy. Of the 9 patients with a final diagnosis of BD-IPMN, the pancreatoscopy identified 78% of the cases correctly.The incidence of post-ERCP pancreatitis was 17%. Pancreatoscopy was found to have provided additional diagnostic information in the vast majority of the cases and to affect clinical decision-making in 76%.

LIMITATIONS: Single-center study.

CONCLUSIONS: Single-operator peroral pancreatoscopy contributed to the clinical evaluation of IPMN lesions and influenced decision-making concerning their clinical management. The problem of post-procedural pancreatitis needs further attention.

sted, utgiver, år, opplag, sider
Elsevier, 2014. Vol. 14, nr 6, s. 510-514
Emneord [en]
ERCP, High-grade dysplasia, IPMN, Pancreatoscopy, Single-operator, SpyGlass
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-132477DOI: 10.1016/j.pan.2014.08.007ISI: 000346552900014PubMedID: 25287157OAI: oai:DiVA.org:umu-132477DiVA, id: diva2:1081759
Forskningsfinansiär
Stockholm County Council, ALF 20130512Tilgjengelig fra: 2017-03-15 Laget: 2017-03-15 Sist oppdatert: 2018-10-10bibliografisk kontrollert

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