Role of SpyGlass-DStm in the preoperative assessment of pancreatic intraductal papillary mucinous neoplasm involving the main pancreatic duct

Takao Ohtsuka, Yoshitaka Gotoh, Yohei Nakashima, Yoshifumi Okayama, So Nakamura, Makiko Morita, Mohammed Y.F. Aly, Vittoria Vanessa D.M. Velasquez, Yasuhisa Mori, Yoshihiko Sadakari, Kohei Nakata, Yoshihiro Miyasaka, Kousei Ishigami, Nao Fujimori, Naoki Mochidome, Yoshinao Oda, Shuji Shimizu, Masafumi Nakamura

Research output: Contribution to journalArticle

Abstract

Background/Objectives: It is often difficult to determine an adequate resection line during pancreatectomy for intraductal papillary mucinous neoplasm involving the main pancreatic duct during partial pancreatectomy. The aim of this study was to evaluate the usefulness of improved peroral pancreatoscopy using SpyGlass-DStm in the preoperative assessment of intraductal papillary mucinous neoplasm involving the main pancreatic duct. Methods: We collected and retrospectively analyzed clinicopathological data from seven consecutive patients who underwent preoperative assessment of intraductal papillary mucinous neoplasm involving the main duct using SpyGlass-DStm. Results: Good imaging quality of the intraductal protruding lesion was obtained in all seven patients, and only one adverse event was noted wherein a patient had mild pancreatitis. Six patients underwent pancreatectomy. In one patient, masked-type concomitant pancreatic ductal adenocarcinoma and low-length dysplastic lesion was found near the surgical margin, which was not detected by preoperative imaging modalities including SpyGlass-DStm. The sensitivity of targeting biopsy during SpyGlass-DStm to diagnose high-grade dysplasia was 0%. Conclusions: SpyGlass-DStm can be safely performed in patients with intraductal papillary mucinous neoplasm involving the main duct, and has excellent visualization of the target lesion. However, challenges include poor diagnostic ability of targeting biopsy, and, therefore, intraoperative frozen section is still needed to obtain negative surgical margins.

Original languageEnglish
Pages (from-to)566-571
Number of pages6
JournalPancreatology
Volume18
Issue number5
DOIs
Publication statusPublished - Jul 2018

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Pancreatic Ducts
Pancreatectomy
Neoplasms
Biopsy
Frozen Sections
Pancreatitis
Adenocarcinoma

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

Cite this

Role of SpyGlass-DStm in the preoperative assessment of pancreatic intraductal papillary mucinous neoplasm involving the main pancreatic duct. / Ohtsuka, Takao; Gotoh, Yoshitaka; Nakashima, Yohei; Okayama, Yoshifumi; Nakamura, So; Morita, Makiko; Aly, Mohammed Y.F.; Velasquez, Vittoria Vanessa D.M.; Mori, Yasuhisa; Sadakari, Yoshihiko; Nakata, Kohei; Miyasaka, Yoshihiro; Ishigami, Kousei; Fujimori, Nao; Mochidome, Naoki; Oda, Yoshinao; Shimizu, Shuji; Nakamura, Masafumi.

In: Pancreatology, Vol. 18, No. 5, 07.2018, p. 566-571.

Research output: Contribution to journalArticle

Ohtsuka, T, Gotoh, Y, Nakashima, Y, Okayama, Y, Nakamura, S, Morita, M, Aly, MYF, Velasquez, VVDM, Mori, Y, Sadakari, Y, Nakata, K, Miyasaka, Y, Ishigami, K, Fujimori, N, Mochidome, N, Oda, Y, Shimizu, S & Nakamura, M 2018, 'Role of SpyGlass-DStm in the preoperative assessment of pancreatic intraductal papillary mucinous neoplasm involving the main pancreatic duct', Pancreatology, vol. 18, no. 5, pp. 566-571. https://doi.org/10.1016/j.pan.2018.04.012
Ohtsuka, Takao ; Gotoh, Yoshitaka ; Nakashima, Yohei ; Okayama, Yoshifumi ; Nakamura, So ; Morita, Makiko ; Aly, Mohammed Y.F. ; Velasquez, Vittoria Vanessa D.M. ; Mori, Yasuhisa ; Sadakari, Yoshihiko ; Nakata, Kohei ; Miyasaka, Yoshihiro ; Ishigami, Kousei ; Fujimori, Nao ; Mochidome, Naoki ; Oda, Yoshinao ; Shimizu, Shuji ; Nakamura, Masafumi. / Role of SpyGlass-DStm in the preoperative assessment of pancreatic intraductal papillary mucinous neoplasm involving the main pancreatic duct. In: Pancreatology. 2018 ; Vol. 18, No. 5. pp. 566-571.
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abstract = "Background/Objectives: It is often difficult to determine an adequate resection line during pancreatectomy for intraductal papillary mucinous neoplasm involving the main pancreatic duct during partial pancreatectomy. The aim of this study was to evaluate the usefulness of improved peroral pancreatoscopy using SpyGlass-DStm in the preoperative assessment of intraductal papillary mucinous neoplasm involving the main pancreatic duct. Methods: We collected and retrospectively analyzed clinicopathological data from seven consecutive patients who underwent preoperative assessment of intraductal papillary mucinous neoplasm involving the main duct using SpyGlass-DStm. Results: Good imaging quality of the intraductal protruding lesion was obtained in all seven patients, and only one adverse event was noted wherein a patient had mild pancreatitis. Six patients underwent pancreatectomy. In one patient, masked-type concomitant pancreatic ductal adenocarcinoma and low-length dysplastic lesion was found near the surgical margin, which was not detected by preoperative imaging modalities including SpyGlass-DStm. The sensitivity of targeting biopsy during SpyGlass-DStm to diagnose high-grade dysplasia was 0{\%}. Conclusions: SpyGlass-DStm can be safely performed in patients with intraductal papillary mucinous neoplasm involving the main duct, and has excellent visualization of the target lesion. However, challenges include poor diagnostic ability of targeting biopsy, and, therefore, intraoperative frozen section is still needed to obtain negative surgical margins.",
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AU - Ohtsuka, Takao

AU - Gotoh, Yoshitaka

AU - Nakashima, Yohei

AU - Okayama, Yoshifumi

AU - Nakamura, So

AU - Morita, Makiko

AU - Aly, Mohammed Y.F.

AU - Velasquez, Vittoria Vanessa D.M.

AU - Mori, Yasuhisa

AU - Sadakari, Yoshihiko

AU - Nakata, Kohei

AU - Miyasaka, Yoshihiro

AU - Ishigami, Kousei

AU - Fujimori, Nao

AU - Mochidome, Naoki

AU - Oda, Yoshinao

AU - Shimizu, Shuji

AU - Nakamura, Masafumi

PY - 2018/7

Y1 - 2018/7

N2 - Background/Objectives: It is often difficult to determine an adequate resection line during pancreatectomy for intraductal papillary mucinous neoplasm involving the main pancreatic duct during partial pancreatectomy. The aim of this study was to evaluate the usefulness of improved peroral pancreatoscopy using SpyGlass-DStm in the preoperative assessment of intraductal papillary mucinous neoplasm involving the main pancreatic duct. Methods: We collected and retrospectively analyzed clinicopathological data from seven consecutive patients who underwent preoperative assessment of intraductal papillary mucinous neoplasm involving the main duct using SpyGlass-DStm. Results: Good imaging quality of the intraductal protruding lesion was obtained in all seven patients, and only one adverse event was noted wherein a patient had mild pancreatitis. Six patients underwent pancreatectomy. In one patient, masked-type concomitant pancreatic ductal adenocarcinoma and low-length dysplastic lesion was found near the surgical margin, which was not detected by preoperative imaging modalities including SpyGlass-DStm. The sensitivity of targeting biopsy during SpyGlass-DStm to diagnose high-grade dysplasia was 0%. Conclusions: SpyGlass-DStm can be safely performed in patients with intraductal papillary mucinous neoplasm involving the main duct, and has excellent visualization of the target lesion. However, challenges include poor diagnostic ability of targeting biopsy, and, therefore, intraoperative frozen section is still needed to obtain negative surgical margins.

AB - Background/Objectives: It is often difficult to determine an adequate resection line during pancreatectomy for intraductal papillary mucinous neoplasm involving the main pancreatic duct during partial pancreatectomy. The aim of this study was to evaluate the usefulness of improved peroral pancreatoscopy using SpyGlass-DStm in the preoperative assessment of intraductal papillary mucinous neoplasm involving the main pancreatic duct. Methods: We collected and retrospectively analyzed clinicopathological data from seven consecutive patients who underwent preoperative assessment of intraductal papillary mucinous neoplasm involving the main duct using SpyGlass-DStm. Results: Good imaging quality of the intraductal protruding lesion was obtained in all seven patients, and only one adverse event was noted wherein a patient had mild pancreatitis. Six patients underwent pancreatectomy. In one patient, masked-type concomitant pancreatic ductal adenocarcinoma and low-length dysplastic lesion was found near the surgical margin, which was not detected by preoperative imaging modalities including SpyGlass-DStm. The sensitivity of targeting biopsy during SpyGlass-DStm to diagnose high-grade dysplasia was 0%. Conclusions: SpyGlass-DStm can be safely performed in patients with intraductal papillary mucinous neoplasm involving the main duct, and has excellent visualization of the target lesion. However, challenges include poor diagnostic ability of targeting biopsy, and, therefore, intraoperative frozen section is still needed to obtain negative surgical margins.

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