CT virtual pancreatoscopy: a new method for diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas

Sata, Naohiro; Kurihara, Kei; Koizumi, Masaru; Tsukahara, Munetoshi; Yoshizawa, Kenichi; Nagai, Hirokazu

doi:10.1007/s00261-005-0359-8

Cited by 16 publications

(6 citation statements)

References 21 publications

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“…54,56,58,60 MRCP and contrast enhanced multidetector thin-cut CT 61,62 are very useful in determining the size and extent of cystic disease, and these may demonstrate a communication between cystic lesions and the pancreatic duct. 61,62 There has been no direct comparison between the clinical yield of MRCP and ductoscopy. In the evaluation of IPMN, IDUS complements pancreatoscopy.…”

Section: Pancreatic Disordersmentioning

confidence: 98%

Cholangioscopy and pancreatoscopy (with videos)

Nguyen

Binmoeller²,

Shah³

2009

Gastrointestinal Endoscopy

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Section: Pancreatic Disordersmentioning

confidence: 98%

Cholangioscopy and pancreatoscopy (with videos)

Nguyen

Binmoeller²,

Shah³

2009

Gastrointestinal Endoscopy

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“…PET-CT has been found to outperform conventional imaging modalities such as CT and MRCP [43,44] with a specificity, sensitivity and accuracy of up to 100, 93 and 95%, respectively [45], for detecting malignant change in pancreatic cystic lesions. Other improvements in imaging include CT virtual pancreatoscopy, which enables better assessment of protruding lesions but requires insertion of a pancreatic nasobiliary tube and injection of carbon dioxide as contrast prior to image capture [46]. In addition to imaging surveillance, the development of clinical symptoms should be taken seriously, since features such as abdominal pain or jaundice may be associated with invasive malignancy [26].…”

Section: Surveillance and Prediction Of Malignant Progression In Bt-imentioning

confidence: 99%

“…Formal pancreatic resection may require pancreaticoduodenectomy, distal pancreatectomy or total pancreatectomy, depending on the site and extent of the disease. Intraductal sonography [48], 3-D MRCP [34] or virtual CT pancreatoscopy [46] can all be employed preoperatively to assess the degree of main-duct extension; however, positive resection margins of up to 30% have been reported [49]. …”

Section: Resections For Bt-ipmnsmentioning

confidence: 99%

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Garcea

Dennison

2011

Pancreatology

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“…Intraductal papillary mucinous neoplasm (IPMN) of the pan− creas is another disease that may possibly benefit from this tech− nique. Two preliminary studies [18,19] on computed tomo− graphic virtual pancreatoscopy for IPMN diagnosis have been re− ported. Unlike magnetic resonance, computed tomography re− quires the endoscopic insertion of a nasopancreatic drainage tube in order to inject the contrast medium or gas.…”

Section: Utility Of Pancreatic Duct Brushing For Diagnosis Of Pancreamentioning

confidence: 99%

ERCP – Pancreatic

Fumex¹,

Ponchon²

2008

Endoscopy

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Endoscopy essentials 79Prophylaxis of post−endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent. (Sofuni et al. Clin Gastroenterol Hepatol 2007 [1]) ! This prospective controlled multicenter trial studied the placement of 5−Fr plastic pancreatic stents to prevent pancreatitis following endo− scopic retrograde cholangiopancreatography (ERCP). A total of 201 consecutive patients who required ERCP (excluding those with pancreatic cancer, pancreas divisum, and those requiring pancreatic duct drainage) were randomized into a stent placement group (n = 98) and a nonstent placement group (n = 103). The success rate of pancreatic stent placement was 96 %, and the rate of spontaneous dislodgement at day 3 was 95.7 %. The primary end point was rate of post− ERCP pancreatitis, which was lower in the stent group (3/94, 3.2 %) compared with the nonstent group (14/103, 13.6 %) (P = 0.019). Prevention of post−ERCP pancreatitis by pancre− atic stent placement has been a hot topic in the past few years. Recent studies have confirmed the efficacy of this approach in high−risk patients [2]. Consequently, Freeman [3] proposed the use of prophylactic pancreatic stents in the following high−risk situations: sphincter of Oddi dysfunc− tion, history of post−ERCP pancreatitis, difficult cannulation, precut sphincterotomy, pancreatic sphincterotomy, aggressive instrumentation of the pancreatic duct, biliary balloon sphincter di− latation, and endoscopic ampullectomy. How− ever, the particular weight of each risk factor for post−ERCP pancreatitis remains largely un− known, and there is currently no consensus among the experts on the appropriate approach [4]. Because it reports results obtained in a large non−high−risk patient group this study is quite interesting. Should we systematically place a pancreatic stent after ERCP? Probably not, but present data suggest that non−high−risk patients may benefit as well from prophylactic pancreatic stent placement. Indeed, but which ones? Only tissue sampling and initial pancreatography sig− nificantly correlated with pancreatitis in univari− ate analysis (multivariate analysis could not be carried out due to the small number of pancreati− tis cases). Currently, it is still too early to recom− mend post−ERCP systematic prophylactic pancre− atic stent placement, even for nonexperienced endoscopists in pancreatic duct cannulation. As suggested by the authors, a large trial is neces− sary to identify patient groups who would bene− fit from this endoscopic post−ERCP approach to pancreatitis prevention. Another interesting point of this study was the high spontaneous migration rate. Here, 3−cm length 5−Fr polyethylene stents unflaged on the pancreatic ductal side were used. The optimal stent type has not been established, but these ones appear to be suitable, as the spontaneous dislodgement rate was 95.7 % after 3 days. Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma. (Uchida et al. J Gastroenterol 2007 [5]) !In ...

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CT virtual pancreatoscopy: a new method for diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas

Cited by 16 publications

References 21 publications

Cholangioscopy and pancreatoscopy (with videos)

Cholangioscopy and pancreatoscopy (with videos)

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

ERCP – Pancreatic

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