Clinical usefulness of a new miniscope in the diagnosis of pancreatic disease

Özkan, Hasan; Saisho, Hiromitsu; Yamaguchi, Taketo; Tsuyuguchi, Toshio; Ishihara, Takeshi; Kikuchi, Yasuharu; Ohto, Masao

doi:10.1016/s0016-5107(95)70054-4

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…A total of 25 articles met the inclusion criteria 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 . The process of article selection and reasons for exclusion are summarized in Fig.…”

Section: Resultsmentioning

confidence: 99%

The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis

et al. 2022

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Introduction: Confirming the diagnosis, invasiveness, and extent of disease of intraductal papillary mucinous neoplasms (IPMN) of the pancreas is challenging. The aim of this study is to summarize the literature on the efficacy and safety of peroral pancreatoscopy (POP) in the diagnosis of IPMN, including the impact of pre- and intraoperative POP on the management of IPMN. Methods: The EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL and Google Scholar databases were systematically searched for articles. Eligible articles investigated cohorts of patients who underwent POP for (suspected) IPMN. Results: Twenty-five articles were identified and included in this review. Twenty-two articles reported on the diagnostic yield of POP in IPMN and eleven articles reported on the effect of pre- or intraoperative POP on clinical decision making. Cannulation, observation rates and overall diagnostic accuracy were high across all studies. Frequently reported visual characteristics of IPMN were intraductal fish-egg-like lesions, hypervascularity, and granular mucosa. Overall, the adverse event rate was 12%, primarily consisting of post-ERCP pancreatitis with a pooled rate of 10%, most of mild severity. Regarding the impact of POP on clinical decision making, in 13-62% of patients POP findings altered the surgical approach. Conclusion: POP is technically successful in the vast majority of patients with (suspected) IPMN, has a considerably high diagnostic accuracy, but an adverse event rate of 12%. Data on intraoperative pancreatoscopy is scarce, but small studies suggest its use can alter surgical management. Future studies are needed to better define the role of POP in the diagnostic work-up of IPMN.

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Section: Resultsmentioning

confidence: 99%

The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis

et al. 2022

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“…Many methods are used in the diagnosis of pancreatic cancer (Ozkan et al, 1995 ;Lee et al, 2009;Kaur et DOI:http://dx.doi.org/10.7314/APJCP.2015.16.14.5619 Pancreatic Cancer: Pathogenesis andDiagnosis 2013;Munroe et al, 2013). The features of these methods are provided in Table 4.…”

Section: Diagnostic Methods In Pancreas Cancermentioning

confidence: 99%

“…Several methods including EUS, magnetic resonance cholangiopancreatography (MRCP), magnetic resonance (MR), computed tomography (BT), positron emission tomography (8) (PET), biopsy (percutaneous or endoscopic), endoscopic approaches (Pancreatoscopy, endoscopic retrograde cholangiopancreatography (Ozkan et al, 1995) (ERCP), optical endomicroscopy, intraductal ultrasonography (Cote et al, 2013;Munroe et al, 2013) (USG), enhanced USG, and elastography are used for early detection of pancreatic cancer, to locate the tumor, to determine invasion, for screening and staging. Because percutaneous biopsy may result in micrometastases (seeding) in younger patients for whom surgery is feasible, it is appropriate in elderly, inoperable patients.…”

Section: Imaging Methodsmentioning

confidence: 99%

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Pancreatic Cancer: Pathogenesis and Diagnosis

Göral¹

2015

Asian Pacific Journal of Cancer Prevention

204

151

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Age, being overweight, smoking, long-term alcohol use, pre-existing chronic pancreatitis, family history, prior abdominal radiotherapy are important risk factors (Table 1) (Wolfgang et al., 2013 AbstractPancreatic cancer is a fatal malignancies which is predominantly seen in men and at advanced age (40-85 years) and has an aggressive course. Its frequency is gradually increasing over the past years. It accounts for 2% of all cancers and 5% of cancer-related deaths. Pancreatic cancer takes the first place among asymptomatic cancers. Ninety percent of cases are adenocarcinomas. Ten percent of the patients have a familial disposition. The disease is very difficult to detect as it has no early signs and spreads rapidly to surrounding organs is one of the most deadly types of cancer. Pancreatic cancer may result from hereditary germline or somatic acquired mutations in cancer-related genes and mutations also cause cancer progression and metastasis.

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“…It can be used for biopsy or lithotripsy in the pancreatic duct under direct visualization [3,4]. A smaller scope with an outer diameter of 1.67 mm and a 0.55-mm forceps channel has been previously described but it lacked an angulation mechanism and could not be used for biopsy [17].…”

Section: Materials Usedmentioning

confidence: 99%

Direct Pancreatoscopy

Kodama¹,

Tatsumi²,

Kozarek³

et al. 2002

Endoscopy

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Objectives and Basic Principles Several imaging procedures, including transabdominal and endoscopic ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic retrograde cholangiopancreatography (ERCP), have been established for the diagnosis of pancreatic diseases. Among them, ERCP is the current gold standard for diagnosis of pancreatic cancer as well as other diseases involving the pancreatic duct. However, it may fail to differentiate strictures or intraluminal filling defects of the pancreatic duct. It may also fail to detect minimal change, and chronic pancreatitis may not be well visualized with contrast medium. Given these limitations, it is necessary to have a modality with a direct approach to the pancreatic duct. Based on this concept, Japanese endoscopists, including Takekoshi et al. [1], first developed peroral pancreatoscopy through the accessory channel of a duodenal fiberscope in 1975. However, this device proved unpopular in clinical use because of problems which included instrument expense, fragility, low visibility, and its relatively large diameter relative to the duodenal papilla. Pancreatoscopy was reassessed and found to be useful for a variety of conditions, including intraductal papillary mucinous tumor (IPMT), first described by Ohashi et al. [2] in 1982. Initial pancreatoscope prototypes had no channel or tip deflection, although subsequent devices of more than 3 or 4 mm in diameter were manufactured with one-or two-way tip deflection, and with an accessory channel with potential use for biopsy or lithotripsy [3, 4]. To make insertion of the scope easier, an ultrathin pancreatoscope (0.8 mm in diameter) was developed by decreasing the number of image guide fibers [3, 5]. Finally, the peroral electronic pancreatoscope (PEPS), the smallest known electronic endoscope, was developed re

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Clinical usefulness of a new miniscope in the diagnosis of pancreatic disease

Cited by 15 publications

References 7 publications

The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis

The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis

Pancreatic Cancer: Pathogenesis and Diagnosis

Direct Pancreatoscopy

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