Yasuda Kenjiro, Sakata Munehiro, Ueda Moose, Uno Koji, Nakajima Masatsugu
Department of Gastroenterology, Kyoto Second Red Cross Hospital, Japan.
Clin Gastroenterol Hepatol. 2005 Jul;3(7 Suppl 1):S53-7. doi: 10.1016/s1542-3565(05)00263-6.
The diagnosis of intraductal papillary mucinous tumor (IPMT) can be performed under the direct visualization of peroral pancreatoscopy (PPS), although the visible field with PPS is limited and endoscopic accessories cannot be easily applied. PPS is useful in cases with IPMT not only for the main duct lesions but also for some of the branch lesions that can be shown through the dilated branch duct. PPS is useful for diagnosing IPMT because histologic diagnosis is possible from biopsy materials obtained by PPS or with radiograph guidance. Histologic findings can be suspected from the appearance and degree of the protrusion of the lesions in the cystic lesion or in the main duct. Thirty patients with IPMT were resected and confirmed histologically. Among them, 26 cases were examined by PPS. Detection rates of the 12 cases with polypoid tumor greater than 3 mm were 67% by PPS, 92% by endoscopic ultrasonography, and 100% by intraductal ultrasonography. Among the 6 cases of adenocarcinoma, 4 cases showed a tumor mass greater than 10 mm.
经口胰管镜检查（PPS）可在直视下对导管内乳头状黏液性肿瘤（IPMT）进行诊断，尽管PPS的可视范围有限且内镜附件不易应用。PPS对IPMT病例有用，不仅适用于主胰管病变，也适用于一些可通过扩张的分支胰管显示的分支病变。PPS对诊断IPMT有用，因为通过PPS获取的活检材料或在影像学引导下获取的活检材料可进行组织学诊断。从囊性病变或主胰管中病变的外观和突出程度可怀疑有组织学发现。30例IPMT患者接受了手术切除并经组织学证实。其中，26例接受了PPS检查。12例息肉样肿瘤大于3mm的病例，PPS的检出率为67%，内镜超声为92%，胰管内超声为100%。在6例腺癌病例中，4例显示肿瘤肿块大于10mm。
