Chen Yang K
University of Colorado at Denver and Health Sciences Center Anschutz Centers for Advanced Medicine, MS F735, 1635 N. Ursula Street, Room OP6710, P.O. Box 6510, Aurora, CO 80045, USA.
Curr Gastroenterol Rep. 2007 Apr;9(2):136-43. doi: 10.1007/s11894-007-0008-1.
Current imaging modalities do not allow for direct access to the pancreatic duct. Because of this limitation, diagnosis and assessment of pancreatic diseases require radiographic imaging and cytologic analysis. Although many of these techniques have excellent specificity for the detection of pancreatic cancer, they offer no therapeutic capabilities and are relatively poor in early detection of cancer and in differentiating chronic pancreatitis from malignancy, particularly when the conditions coexist. Currently available cholangioscopes are too large to access the pancreatic duct without sphincterotomy or balloon dilation, increasing the risk of instrumentation trauma to the pancreas. Novel, dedicated pancreatoscopes have recently been developed and are under investigation in clinical trials. Preliminary evidence suggests that these new technologies allow for direct visualization of the pancreatic ducts, with the potential for forceps biopsy in suspected malignancy and endotherapy for pancreatic calculi. Future and ongoing clinical trials will better define the utility and roles of these new endoscopy tools.
目前的成像方式无法直接进入胰管。由于这一限制，胰腺疾病的诊断和评估需要进行放射成像和细胞学分析。尽管这些技术中的许多对胰腺癌的检测具有出色的特异性，但它们没有治疗能力，在癌症的早期检测以及区分慢性胰腺炎和恶性肿瘤方面相对较差，尤其是当这两种情况并存时。目前可用的胆管镜太大，无法在不进行括约肌切开术或球囊扩张的情况下进入胰管，这增加了胰腺器械创伤的风险。新型的专用胰管镜最近已被开发出来，并正在临床试验中进行研究。初步证据表明，这些新技术能够直接观察胰管，有可能对疑似恶性肿瘤进行钳取活检，并对胰腺结石进行内镜治疗。未来和正在进行的临床试验将更好地确定这些新型内镜工具的效用和作用。
