Electronic pancreatoscopy for the diagnosis of pancreatic diseases
| Autor: | Tadashi Kodama, Yoshihide Tatsumi, Hisakazu Yamagishi, Yukio Yamane, Mitsumasa Abe, Tatsuya Koshitani, Keimei Kato, Yoichi Imamura, Yoshiyuki Horii, Naoki Wakabayashi, Hideki Sato |
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| Rok vydání: | 2002 |
| Předmět: |
Pathology
medicine.medical_specialty Pancreatic disease Sensitivity and Specificity Pancreatic cancer medicine Humans Endoscopy Digestive System Pancreas Pancreatic duct Hepatology medicine.diagnostic_test business.industry Gastroenterology Pancreatic Diseases Equipment Design Image Enhancement medicine.disease Electronics Medical Endoscopy medicine.anatomical_structure Feasibility Studies Acute pancreatitis Adenocarcinoma Pancreatitis business |
| Zdroj: | The American Journal of Gastroenterology. 97:617-622 |
| ISSN: | 1572-0241 0002-9270 |
| DOI: | 10.1111/j.1572-0241.2002.05539.x |
| Popis: | OBJECTIVES: Diagnostic pancreatoscopy was performed in 56 patients using the newly developed peroral electronic pancreatoscope (PEPS). The diagnostic value of the PEPS for pancreatic diseases was evaluated. METHODS: The PEPS (external diameter = 2.1 mm, bidirectional tip deflection) was developed with a minute 50,000-pixel interline charge-coupled device. Pancreatoscopy was performed by means of an endoscopic retrograde approach without sphincterotomy. The cases examined were normal (three), chronic pancreatitis (32), pancreatic cancer (eight), and intraductal papillary mucinous tumors (13). RESULTS: Of the 56 cases, 42 (75%) were adequately seen. In normal cases, fine capillary vessels were clearly visualized on the smooth whitish-pink mucosa. Findings in chronic pancreatitis included protein plugs, calcified stones, rough whitish mucosa, scar formation, edema, erythema, and indistinct capillary appearance. All the stenoses of chronic pancreatitis could be differentiated from those of pancreatic cancer with the PEPS. In the pancreatic cancer cases, all patients had stenoses or duct cutoffs; most cases had friable mucosa with erythema and erosive changes, and a single patient had a compressed pancreatic duct wall covered with normal epithelium. In the cases of intraductal papillary mucinous tumors, papillary tumors were visualized with extreme clarity. In the case of adenocarcinoma, the PEPS revealed oval-shaped tumors with spotty redness or villous tumors with dilation of capillary vessels. Moderate acute pancreatitis was recognized after pancreatoscopy in one of the 56 cases (1.8%). CONCLUSIONS: Electronic pancreatoscopy with the PEPS is feasible in most patients and technically safe, and improves diagnostic yield over conventional pancreatoscopy. |
| Databáze: | OpenAIRE |
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