TY - JOUR
T1 - Intracystic biopsy and diagnosis of intraductal papillary mucinous neoplasm via SpyGlass pancreatoscopy
AU - Tanaka, Shoichiro A.
AU - McKee, John D.
AU - Conway, W. Charles
N1 - Publisher Copyright:
© Academic Division of Ochsner Clinic Foundation.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Intraductal papillary mucinous neoplasm (IPMN) of the pancreas carries a risk of malignancy ranging from 15%-60%, depending on certain high-risk features. Diagnostic efforts often include radiographic imaging with computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography, and endoscopic ultrasound. Once IPMN has been diagnosed, the proposed indications for cyst resection are based primarily on size, main duct involvement, symptoms, and the presence of mural nodules. Diagnostic difficulty still remains, however, in patients with small lesions and with normal carcinoembryonic antigen levels, so alternative endoscopic modalities are needed. Case Report: We report a case of intracystic SpyGlass Direct Visualization System (Boston Scientific) evaluation and biopsy of an IPMN in a 74-year-old male patient who presented to our surgical clinic with a history of chronic pancreatitis and significant weight loss during the last 2½ years. Conclusion: In difficult diagnostic cases, SpyGlass pancreatoscopy can be quite useful because the device allows direct endoscopic visualization of the pancreaticobiliary ducts. Ductal pathology, including stones, strictures, and proliferative epithelial abnormalities, can be observed and even directly biopsied. Early experience in applying this technology to pancreatic cyst evaluation has indicated improved diagnostic accuracy.
AB - Intraductal papillary mucinous neoplasm (IPMN) of the pancreas carries a risk of malignancy ranging from 15%-60%, depending on certain high-risk features. Diagnostic efforts often include radiographic imaging with computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography, and endoscopic ultrasound. Once IPMN has been diagnosed, the proposed indications for cyst resection are based primarily on size, main duct involvement, symptoms, and the presence of mural nodules. Diagnostic difficulty still remains, however, in patients with small lesions and with normal carcinoembryonic antigen levels, so alternative endoscopic modalities are needed. Case Report: We report a case of intracystic SpyGlass Direct Visualization System (Boston Scientific) evaluation and biopsy of an IPMN in a 74-year-old male patient who presented to our surgical clinic with a history of chronic pancreatitis and significant weight loss during the last 2½ years. Conclusion: In difficult diagnostic cases, SpyGlass pancreatoscopy can be quite useful because the device allows direct endoscopic visualization of the pancreaticobiliary ducts. Ductal pathology, including stones, strictures, and proliferative epithelial abnormalities, can be observed and even directly biopsied. Early experience in applying this technology to pancreatic cyst evaluation has indicated improved diagnostic accuracy.
KW - Carcinoma-pancreatic ductal
KW - Image-guided biopsy
KW - Pancreatectomy
KW - Pancreatic neoplasms
KW - Pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=84949228484&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84949228484
SN - 1524-5012
VL - 15
SP - 452
EP - 454
JO - Ochsner Journal
JF - Ochsner Journal
IS - 4
ER -