Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Division of Gastroenterology, Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, United States.
Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, United States.
Endoscopy. 2018 Nov;50(11):1095-1098. doi: 10.1055/a-0596-7374. Epub 2018 Apr 26.
The aim of this study was to investigate the outcomes of digital pancreatoscopy in main duct intraductal papillary mucinous neoplasm (MD-IPMN).
This was a multicenter retrospective study. Outcomes analyzed were safety, incremental pathology yield compared with previous cross-sectional/endoscopic ultrasound (EUS) imaging, and whether the surgical procedure was dictated by the pancreatoscopy.
A total of 31 patients were enrolled from six tertiary care centers. Overall, 42 % of cases had findings on pancreatoscopy that were not seen on cross-sectional imaging or EUS. Digital pancreatoscopy dictated the type of surgery performed in 13 patients (42 %) who underwent surgery. However, in patients with a diffusely dilated pancreatic duct (> 10 mm), the pancreatoscopy dictated the type of surgery in 77 % of cases vs. 17 % of cases in the focally dilated pancreatic duct group (10/13 vs. 3/18; = 0.001).
Digital pancreatoscopy should be considered in the diagnostic algorithm of MD-IPMN in patients with a diffusely dilated pancreatic duct and without any focal lesions seen on cross-sectional imaging or EUS.
本研究旨在探讨胰管内镜在主胰管内乳头状黏液性肿瘤（MD-IPMN）中的应用结果。
这是一项多中心回顾性研究。分析的结果包括安全性、与先前的横断面/内镜超声（EUS）成像相比增量病理学检出率，以及手术是否由胰管内镜决定。
从六个三级护理中心共纳入 31 例患者。总体而言，42%的病例在胰管内镜下发现的结果在横断面成像或 EUS 上未见到。13 例（42%）接受手术的患者中，胰管内镜决定了手术类型。然而，在胰管弥漫性扩张（>10mm）的患者中，胰管内镜决定手术类型的比例为 77%，而在胰管局限性扩张（10/13 例 vs. 3/18 例；=0.001）的患者中为 17%。
对于在横断面成像或 EUS 上未见任何局灶性病变的胰管弥漫性扩张的 MD-IPMN 患者，应考虑将数字胰管内镜纳入其诊断算法中。
