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Single-operator per...
Single-operator peroral pancreatoscopy in the preoperative diagnostics of suspected main duct intraductal papillary mucinous neoplasms : efficacy and novel insights on complications
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- Vehviläinen, Sini (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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- Fagerström, Niklas (author)
- Karolinska Institutet
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- Valente, Roberto (author)
- Umeå universitet,Kirurgi,Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
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- Seppänen, Hanna (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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- Udd, Marianne (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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- Lindström, Outi (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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- Mustonen, Harri (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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- Swahn, Fredrik (author)
- Department of Surgery, Skåne University Hospital, Lund, Sweden
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- Arnelo, Urban (author)
- Karolinska Institutet,Umeå universitet,Kirurgi,Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
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- Kylänpää, Leena (author)
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland; Translational Cancer Medicine Research Program, University of Helsinki, Helsinki, Finland
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(creator_code:org_t)
- 2022-03-11
- 2022
- English.
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In: Surgical Endoscopy. - : Springer. - 0930-2794 .- 1432-2218. ; 36, s. 7431-7443
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Abstract
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- Background: Distinguishing intraductal papillary mucinous neoplasms (IPMNs) from other pancreatic cystic lesions is essential since IPMNs carry the risk of becoming malignant. Differentiating the main pancreatic duct involving IPMNs (MD-IPMNs) through conventional imaging is deficient. Single-operator peroral pancreatoscopy (SOPP) represents a promising method offering additional information on suspected lesions in the pancreatic main duct (MD). We aimed to determine the role of SOPP in the preoperative diagnostics of suspected MD-IPMNs and identify factors contributing to SOPP-related complications.Materials and Methods: In this primarily retrospective study, SOPPs were performed at three high-volume centers on suspected MD-IPMNs. Primary outcome was the clinical impact of SOPP to subsequent patient care. Additionally, we documented post-SOPP complications and analyzed several assumed patient- and procedure-related risk factors.Results: One hundred and one (101) SOPPs were performed. Subsequent clinical management was affected due to the findings in 86 (85%) cases. Surgery was planned for 29 (29%) patients. A condition other than IPMN explaining MD dilatation was found in 28 (28%) cases. In 35 (35%) cases, follow-up with MRI was continued. Post-SOPP pancreatitis occurred in 20 (20%) patients and one of them was fatal. A decrease in odds of post-SOPP pancreatitis was seen as the MD diameter increases (OR 0.714 for 1.0 mm increase in MD diameter, CI 95% 0.514–0.993, p = 0.045). Furthermore, a correlation between lower MD diameter values and higher severity post-SOPP pancreatitis was seen (TJT = 599, SE = 116.6, z = − 2.31; p = 0.020). History of pancreatitis after endoscopic retrograde cholangiopancreatography was a confirmed risk factor for post-SOPP pancreatitis. Conclusions between complications and other risk factors could not be drawn.Conclusion: SOPP aids clinical decision-making in suspected MD-IPMNs. Risk for post-SOPP pancreatitis is not negligible compared to non-invasive imaging methods. The risk for pancreatitis decreases as the diameter of the MD increases.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- IPMN
- Pancreatitis
- Post-ERCP pancreatitis
- Single-operator pancreatoscopy
- Surgery
- kirurgi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Vehviläinen, Sin ...
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Fagerström, Nikl ...
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Valente, Roberto
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Seppänen, Hanna
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Udd, Marianne
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Lindström, Outi
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show more...
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Mustonen, Harri
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Swahn, Fredrik
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Arnelo, Urban
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Kylänpää, Leena
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Surgical Endosco ...
- By the university
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Umeå University
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Karolinska Institutet