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Original Article
- 22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions
- Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Tomoaki Tashima, Yumi Mashimo, Shomei Ryozawa
- Clin Endosc 2024;57(2):237-245. Published online January 26, 2024
- DOI: https://doi.org/10.5946/ce.2023.011
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Graphical Abstract
Abstract
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ePub - Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions.
Methods
Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S).
Results
A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03).
Conclusions
Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure. -
Citations
Citations to this article as recorded by
- The correlation between tumoral CD8 expression and clinical course in patients with unresectable pancreatic cancer using tissue samples acquired by endoscopic ultrasound‐guided tissue acquisition
Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Ryuichi Watanabe, Ryo Sato, Masanori Yasuda
Journal of Hepato-Biliary-Pancreatic Sciences.2025; 32(2): 132. CrossRef - Curved puncture technique using a flexible stainless-steel needle in endoscopic ultrasound-guided hepaticogastrostomy
Haruo Miwa, Yuichi Suzuki, Shotaro Tsunoda, Kazuki Endo, Ritsuko Oishi, Hiromi Tsuchiya, Shin Maeda
Endoscopy.2024; 56(S 01): E1082. CrossRef - Optimal tissue acquisition method for pancreatic mass
Kwang Hyun Chung, Sang Hyub Lee
Digestive Endoscopy.2024;[Epub] CrossRef
- The correlation between tumoral CD8 expression and clinical course in patients with unresectable pancreatic cancer using tissue samples acquired by endoscopic ultrasound‐guided tissue acquisition
- 3,347 View
- 163 Download
- 3 Web of Science
- 3 Crossref
Review
- Endoscopic Ultrasound-Guided Pancreatic Transmural Stenting and Transmural Intervention
- Takeshi Ogura, Hideko Ohama, Kazuhide Higuchi
- Clin Endosc 2020;53(4):429-435. Published online November 27, 2019
- DOI: https://doi.org/10.5946/ce.2019.130
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Abstract
PDFPubReaderePub
- Endoscopic ultrasound (EUS)-guided pancreatic access is an emergent method that can be divided into the two main techniques of EUS-guided rendezvous and pancreatic transmural stenting (PTS). While many reports have described EUS-guided procedures, the indications, technical tips, clinical effects, and safety of EUS-guided pancreatic duct drainage (EUS-PD) remain controversial. This review describes the current status of and problems associated with EUS-PD, particularly PTS. We reviewed clinical data derived from a total of 334 patients. Rates of technical and clinical success ranged from 63% to 100% and 76% to 100%, respectively. In contrast, the rate of procedure-related adverse events was high at 26.7% (89/334). The most frequent adverse events comprised abdominal pain (n=38), acute pancreatitis (n=15), bleeding (n=9), and issues associated with pancreatic juice leakage such as perigastric fluid, pancreatic fluid collection, or pancreatic juice leaks (n=8). In conclusion, indications for EUS-PTS are limited, as is the evidence of its viability, due to the scarcity of expert operators. Despite improvements made to various devices, EUS-PTS remains technically challenging. Therefore, a long-term, large-scale, multicenter study is required to establish this technique as a viable alternative drainage method.
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Citations
Citations to this article as recorded by- Training and quality indicators in interventional endoscopic ultrasound
Bogdan Miutescu, Vinay Dhir
Digestive Endoscopy.2025; 37(1): 40. CrossRef - Endoscopic Ultrasound-guided Pancreatic Duct Drainage: A Systematic Review and Meta-analysis
Ruixia Wang, Tong Su, Changqin Xu, Tong Xiao, Hongwei Xu, Xiuju Shi, Shulei Zhao
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef - Needle-free technique for guidewire manipulation during endoscopic ultrasound-guided pancreatic duct drainage
Takeshi Ogura, Masahiro Yamamura, Mitsuki Tomita, Jun Sakamoto, Hiroki Nishikawa
Endoscopy.2024; 56(S 01): E184. CrossRef - EUS-guided pancreatic duct drainage: a single-center observational study
Elodie Romailler, Anouk Voutaz, Sarra Oumrani, Mariola Marx, Maxime Robert, Fabrice Caillol, Alain Schoepfer, Sébastien Godat
iGIE.2024; 3(2): 237. CrossRef - Endoscopic ultrasound-guided pancreatic duct drainage: a comprehensive state of the art review
Jayanta Samanta, Abhirup Chatterjee, Jahnvi Dhar, Zaheer Nabi, Michiel Bronswijk, Manik Aggarwal, Antonio Facciorusso, Paraskevas Gkolfakis, Takeshi Ogura, Schalk Van der Merwe, Sundeep Lakhtakia
Expert Review of Gastroenterology & Hepatology.2024; 18(7): 351. CrossRef - Mechanical evaluation of the dilation force of dilation devices during interventional endoscopic ultrasound
Takeshi Ogura, Saori Ueno, Akitoshi Hakoda, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Masahiro Yamamura, Nobuhiro Hattori, Kimi Bessho, Hiroki Nishikawa, Rie Kanaoka, Youhei Kurose
Endoscopy International Open.2024; 12(08): E955. CrossRef - Safety and efficacy of endoscopic ultrasound-guided pancreatic duct drainage using a drill dilator: a retrospective study in Japan
Ahmed Sadek, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto, Kenneth Tachi
Clinical Endoscopy.2024; 57(5): 666. CrossRef - A novel fluoroscopic system improves visibility of devices during endoscopic ultrasound-guided pancreatic duct drainage
Takeshi Ogura, Yuki Uba, Nobuhiro Hattori, Kimi Bessho, Hiroki Nishikawa
Endoscopy.2024; 56(S 01): E831. CrossRef - A novel spiral dilator for pancreatic duct drainage: catching two birds with one stone
Han Taek Jeong, Jimin Han
Clinical Endoscopy.2024; 57(5): 608. CrossRef - Pancreatic Duct Stenting: Does Interventional Radiology Have a Role?
Shriya L. Veluri, Ahmad Arar, Akhilesh Pillai, Gautam Chamarthy, Thomas Tielleman, Anil K. Pillai
Digestive Disease Interventions.2024;[Epub] CrossRef - Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study
Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa
Endoscopy International Open.2024;[Epub] CrossRef - Best Practices in Pancreatico-biliary Stenting and EUS-guided Drainage
Renato Medas, Joel Ferreira-Silva, Mohit Girotra, Monique Barakat, James H. Tabibian, Eduardo Rodrigues-Pinto
Journal of Clinical Gastroenterology.2023; 57(6): 553. CrossRef - Endoscopic treatment of pancreatholithiasis
Ichiro YASUDA, Toshiki ENTANI, Jun MATSUNO, Nobuhiko HAYASHI, Keisuke IWATA
Suizo.2023; 38(4): 201. CrossRef - Endoscopic pancreatic drainage
Toshifumi KIN, Kazuki HAMA, Kenta YOSHIDA, Risa NAKAMURA, Ryo ANDO, Kosuke IWANO, Haruka TOYONAGA, Tatsuya ISHII, Masayo MOTOYA, Tsuyoshi HAYASHI, Kuniyuki TAKAHASHI, Akio KATANUMA
Suizo.2023; 38(4): 192. CrossRef - Efficacy and Safety of Peroral Pancreatoscopy Through the Fistula Created by Endoscopic Ultrasound–Guided Pancreaticogastrostomy
Akinori Suzuki, Shigeto Ishii, Toshio Fujisawa, Hiroaki Saito, Yusuke Takasaki, Sho Takahashi, Wataru Yamagata, Kazushige Ochiai, Ko Tomishima, Hiroyuki Isayama
Pancreas.2022; 51(3): 228. CrossRef - Endoscopic ultrasound-guided pancreaticoduodenostomy with a forward-viewing echoendoscope
Shigenobu Yoshimura, So Nakaji, Toshiyasu Shiratori, Natsuki Kawamitsu, Shin Inoue
VideoGIE.2021; 6(12): 549. CrossRef - Endoscopic Ultrasound-Guided Pancreatic Duct Drainage: Techniques and Literature Review of Transmural Stenting
Akira Imoto, Takeshi Ogura, Kazuhide Higuchi
Clinical Endoscopy.2020; 53(5): 525. CrossRef - Technical tips for endoscopic ultrasound-guided pancreatic duct access and drainage
Yousuke Nakai
International Journal of Gastrointestinal Intervention.2020; 9(4): 154. CrossRef
- Training and quality indicators in interventional endoscopic ultrasound
- 6,551 View
- 288 Download
- 15 Web of Science
- 18 Crossref
Original Articles
- Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis
- Jonathan B. Reichstein, Vaishali Patel, Parit Mekaroonkamol, Sunil Dacha, Steven A. Keilin, Qiang Cai, Field F. Willingham
- Clin Endosc 2020;53(1):73-81. Published online July 5, 2019
- DOI: https://doi.org/10.5946/ce.2019.052
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Abstract
PDFPubReaderePub
- Background
/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US.
Methods
An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios.
Results
The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP.
Conclusions
A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP -
Citations
Citations to this article as recorded by- Controversies in ERCP
Christoph F. Dietrich, Noor L. Bekkali, Sean Burmeister, Yi Dong, Simon M. Everett, Michael Hocke, Andre Ignee, Wei On, Srisha Hebbar, Kofi Oppong, Siyu Sun, Christian Jenssen, Barbara Braden
Endoscopic Ultrasound.2022; 11(1): 27. CrossRef - Controversies in ERCP
Christoph F. Dietrich, Noor L. Bekkali, Sean Burmeister, Yi Dong, Simon M. Everett, Michael Hocke, Andre Ignee, Wei On, Srisha Hebbar, Kofi Oppong, Siyu Sun, Christian Jenssen, Barbara Braden
Endoscopic Ultrasound.2022; 11(3): 186. CrossRef - Biliary hitch and ride technique for blind pancreatic duct cannulation
Juan J. Vila, Juan Carrascosa, Ignacio Fernández-Urién, Paul Yeaton, Gonzalo González, Leire Aburruza, José Manuel Zozaya
Endoscopy.2021; 53(01): E29. CrossRef - Endoscopic Retrograde Cholangiopancreatography in Recurrent Acute Pancreatitis: Determining the Optimal Subgroup of Patients in Whom the Procedure is Beneficial
Tae Yoon Lee, Takuji Iwashita
Clinical Endoscopy.2020; 53(1): 5. CrossRef
- Controversies in ERCP
- 5,425 View
- 189 Download
- 4 Web of Science
- 4 Crossref
- Diagnostic Efficacy of Endoscopic Ultrasound Elastography in Differentiating Solid Pancreatic Lesions: A Single-Center Experience
- Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy
- Clin Endosc 2019;52(4):360-364. Published online January 8, 2019
- DOI: https://doi.org/10.5946/ce.2018.160
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Abstract
PDFPubReaderePub
- Background
/Aims: Endoscopic ultrasound (EUS) has a limited ability to determine the nature of solid pancreatic lesions (SPLs). Most recent ultrasound processors are provided with elastography software, which allows quantification of the tissue hardness. The aim of this study is to evaluate the effectiveness of the elasticity score (ES) and strain ratio (SR) in the differentiation of benign pancreatic lesions from malignant pancreatic lesions.
Methods
The study had a retrospective design; it included 97 patients with SPLs and 19 patients with inflammatory lesions. The ES and SR were determined during the examination; finally, EUS-guided fine needle aspiration was performed.
Results
In this 2-year study, 116 patients were enrolled (97 with malignant lesions and 19 with benign lesions). There were 69 men and 47 women. Their median age was 55.9 years. A cut-off point was detected at SR of 7.75 with a specificity of 99.9%, sensitivity of 90.7%, positive predictive value (PPV) of 99.9%, negative predictive value (NPV) of 67.9%, and accuracy of 92.2%. After adding the ES to the SR, the cut-off point at 7.75 resulted in a specificity of 94.6%, sensitivity of 99%, PPV of 98%, NPV of 98.5%, and accuracy of 97%.
Conclusions
The use of the ES combined with the SR increases the accuracy of differentiation between benign and malignant SPLs and is an effective method for the evaluation of pancreatic masses. -
Citations
Citations to this article as recorded by- Diagnostic performance of endoscopic ultrasound elastography for differential diagnosis of solid pancreatic lesions: A propensity score-matched analysis
In Rae Cho, Seok-Hoo Jeong, Huapyong Kang, Eui Joo Kim, Yeon Suk Kim, Soyoung Jeon, Jae Hee Cho
Pancreatology.2023; 23(1): 105. CrossRef - The expanding role of endoscopic ultrasound elastography
Jahnvi Dhar, Jayanta Samanta
Clinical Journal of Gastroenterology.2022; 15(5): 841. CrossRef - Endoscopic ultrasound elastography for malignant pancreatic masses and associated lymph nodes: Critical evaluation of strain ratio cutoff value
Miguel Puga-Tejada, Raquel Del Valle, Roberto Oleas, Maria Egas-Izquierdo, Martha Arevalo-Mora, Jorge Baquerizo-Burgos, Jesenia Ospina, Miguel Soria-Alcivar, Hannah Pitanga-Lukashok, Carlos Robles-Medranda
World Journal of Gastrointestinal Endoscopy.2022; 14(9): 524. CrossRef - Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer
Yasutaka Ishii, Masahiro Serikawa, Tomofumi Tsuboi, Ryota Kawamura, Ken Tsushima, Shinya Nakamura, Tetsuro Hirano, Ayami Fukiage, Takeshi Mori, Juri Ikemoto, Yusuke Kiyoshita, Sho Saeki, Yosuke Tamura, Sayaka Miyamoto, Kazuaki Chayama
Diagnostics.2021; 11(2): 238. CrossRef - Impact of endoscopic ultrasound elastography in pancreatic lesion evaluation
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha
Artificial Intelligence in Gastrointestinal Endoscopy.2021; 2(4): 168. CrossRef - Utilidad de la elastografía cuantitativa por ultrasonografía endoscópica (USE), para el diagnóstico de las lesiones sólidas del páncreas (LSP).
Martín Alonso Gómez Zuleta, Oscar Fernando Ruíz Morales, Diego Fernando Cano Rosales
Revista colombiana de Gastroenterología.2021; 36(4): 434. CrossRef
- Diagnostic performance of endoscopic ultrasound elastography for differential diagnosis of solid pancreatic lesions: A propensity score-matched analysis
- 5,718 View
- 152 Download
- 4 Web of Science
- 6 Crossref
Case Report
- A Rare Case of Early Gastric Cancer Combined with Underlying Heterotopic Pancreas
- Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song
- Clin Endosc 2018;51(2):192-195. Published online August 31, 2017
- DOI: https://doi.org/10.5946/ce.2017.055
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Abstract
PDFPubReaderePub
- Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas. Distal gastrectomy was performed, which confirmed an early gastric cancer confined to the mucosa, and a separate underlying heterotopic pancreas. Although heterotopic pancreas is most likely benign, careful endoscopic observation of the mucosal surface is necessary to avoid overlooking a coincident early gastric cancer.
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Citations
Citations to this article as recorded by- Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review
Shinya Kawaguchi, Akinori Murakami, Masato Nishida
Internal Medicine.2023; 62(5): 723. CrossRef - Gastric ectopic pancreas combined with synchronous multiple early gastric cancer: A rare case report
Zhen-Ya Zhao, Yue-Xing Lai, Ping Xu
World Journal of Clinical Cases.2023; 11(7): 1569. CrossRef - A rare case of enlarged gastric heterotopic pancreas with retention cysts: A case report and literature review
Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
International Journal of Surgery Case Reports.2020; 74: 284. CrossRef - A case of gastric heterotopic pancreas with gastroduodenal invagination
Shoko Iwahashi, Masaaki Nishi, Toshiaki Yoshimoto, Hideya Kashihara, Chie Takasu, Takuya Tokunaga, Tomohiko Miyatani, Jun Higashijima, Kozo Yoshikawa, Yuma Wada, Yoshimi Bando, Mitsuo Shimada
Surgical Case Reports.2019;[Epub] CrossRef
- Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review
- 7,472 View
- 191 Download
- 5 Web of Science
- 4 Crossref
Review
- Management of Benign and Malignant Pancreatic Duct Strictures
- Enad Dawod, Michel Kahaleh
- Clin Endosc 2018;51(2):156-160. Published online July 20, 2017
- DOI: https://doi.org/10.5946/ce.2017.085
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Abstract
PDFPubReaderePub
- The diagnosis and management of pancreatic strictures, whether malignant or benign, remain challenging. The last 2 decades have seen dramatic progress in terms of both advanced imaging and endoscopic therapy. While plastic stents remain the cornerstone of the treatment of benign strictures, the advent of fully covered metal stents has initiated a new wave of interest in calibrating the pancreatic duct with fewer sessions. In malignant disease, palliation remains the priority and further data are necessary before offering systematic pancreatic stenting.
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Citations
Citations to this article as recorded by- Management of Pancreatic Duct Strictures, Leaks, and Disconnected Pancreatic Duct Syndrome
Surinder Singh Rana, Sanish Ancil
Gastroenterology Clinics of North America.2025; 54(1): 75. CrossRef - Endoscopic Ultrasound-guided Pancreatic Fluid collection drainage and Pancreatic Ductal drainage
Sridhar Sundaram, Surinder Rana
Techniques and Innovations in Gastrointestinal Endoscopy.2025; : 250921. CrossRef - EUS-guided pancreatic duct drainage: a single-center observational study
Elodie Romailler, Anouk Voutaz, Sarra Oumrani, Mariola Marx, Maxime Robert, Fabrice Caillol, Alain Schoepfer, Sébastien Godat
iGIE.2024; 3(2): 237. CrossRef - Role of peroral cholangioscopy and pancreatoscopy in the diagnosis and treatment of biliary and pancreatic disease: past, present, and future
Harishankar Gopakumar, Neil R. Sharma
Frontiers in Gastroenterology.2023;[Epub] CrossRef - EUS-guided drainage of the pancreatic duct for the treatment of postoperative stenosis of pancreatico-digestive anastomosis or pancreatic duct stenosis complicating chronic pancreatitis: Experience at a tertiary care center
Franz Rudler, Fabrice Caillol, Jean-Philippe Ratone, Christian Pesenti, Jean-Christophe Valats, Alexei Soloveyv, Marc Giovannini
Endoscopic Ultrasound.2022; 11(4): 296. CrossRef - Ruptured Splenic Artery Pseudoaneurysm Causing Hemorrhage Into a Pancreatic Pseudocyst
Zo C. Overton-Hennessy, A. Michael Devane, Steve Fiester, Noah Schammel, Christine Schammel, James W. Fulcher
American Journal of Forensic Medicine & Pathology.2022; 43(1): 76. CrossRef - Percutaneous transluminal angioplasty balloons for endoscopic ultrasound-guided pancreatic duct interventions
Jad P AbiMansour, Barham K Abu Dayyeh, Michael J Levy, Andrew C Storm, John A Martin, Bret T Petersen, Ryan J Law, Mark D Topazian, Vinay Chandrasekhara
World Journal of Gastrointestinal Endoscopy.2022; 14(8): 487. CrossRef - Image-Guided Percutaneous Pancreatic Duct Drainage: A 10-Year Observational Study
Malkhaz Mizandari, Tamta Azrumelashvili, Pedram Keshavarz, Nagy Habib
Journal of Vascular and Interventional Radiology.2021; 32(7): 1075. CrossRef - Long-term outcomes of fully covered self-expandable metal stents versus plastic stents in chronic pancreatitis
Sang Hoon Lee, Yeon Suk Kim, Eui Joo Kim, Hee Seung Lee, Jeong Youp Park, Seung Woo Park, Si Young Song, Jae Hee Cho, Seungmin Bang
Scientific Reports.2021;[Epub] CrossRef - Approach to management of pancreatic strictures: the gastroenterologist’s perspective
Vaneet Jearth, Suprabhat Giri, Sridhar Sundaram
Clinical Journal of Gastroenterology.2021; 14(6): 1587. CrossRef - International consensus guidelines on interventional endoscopy in chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancr
Masayuki Kitano, Thomas M. Gress, Pramod K. Garg, Takao Itoi, Atsushi Irisawa, Hiroyuki Isayama, Atsushi Kanno, Kei Takase, Michael Levy, Ichiro Yasuda, Phillipe Lévy, Shuiji Isaji, Carlos Fernandez-Del Castillo, Asbjørn M. Drewes, Andrea R.G. Sheel, John
Pancreatology.2020; 20(6): 1045. CrossRef - Recent advances in the diagnosis and management of chronic pancreatitis
Chang-Il Kwon, Jae Hee Cho, Sung Hoon Choi, Kwang Hyun Ko, Temel Tirkes, Mark A. Gromski, Glen A. Lehman
The Korean Journal of Internal Medicine.2019; 34(2): 242. CrossRef - Endoscopic and Conservative Management of Chronic Pancreatitis and Its Complications
Alexander Waldthaler, Roberto Valente, Urban Arnelo, J.-Matthias Löhr
Visceral Medicine.2019; 35(2): 98. CrossRef
- Management of Pancreatic Duct Strictures, Leaks, and Disconnected Pancreatic Duct Syndrome
- 39,427 View
- 284 Download
- 12 Web of Science
- 13 Crossref
Focused Review Series: Training in Endoscopy
- Training in Endoscopy: Endoscopic Retrograde Cholangiopancreatography
- Jaihwan Kim
- Clin Endosc 2017;50(4):334-339. Published online July 13, 2017
- DOI: https://doi.org/10.5946/ce.2017.068
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Abstract
PDFPubReaderePub
- Endoscopic retrograde cholangiopancreatography (ERCP) is a key endoscopy skill used to diagnose and treat pancreatobiliary diseases. However, its diagnostic use is decreasing in favor of other less invasive methods such as magnetic resonance cholangiopancreatography and endoscopic ultrasound. Alternatively, its use has become more important in the therapeutic area. ERCP trainees must know the anatomy and physiology of the pancreatobiliary system, several key basic skills, and complications of a successful procedure. This article briefly introduces basic ERCP knowledge, techniques, numbers necessary to achieve competency, and complications for new ERCP operators.
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Citations
Citations to this article as recorded by- Variables endoscópicas pre procedimiento asociadas a canulación difícil en colangiopancreatografía retrógrada endoscópica en un hospital de referencia de Lima, Perú
Wilmer Gustavo Quiroga-Purizaca, Diego Ricardo Páucar-Aguilar, Emma Calderón-Yeren, Daniel Andrei Vargas-Blácido
Revista de Gastroenterología del Perú.2025; 45(1): 32. CrossRef - Comparing sedation protocols for endoscopic retrograde cholangiopancreatography (ERCP): A retrospective study
Ning Zhang, Guanjun Li
Heliyon.2024; 10(5): e27447. CrossRef - Vía biliar normal en pacientes con sospecha de coledocolitiasis sometidos a CPRE estudio de casos y controles
Daniel A Portillo Rodríguez, Sergio Morales Polanco, Juan de Dios Díaz Rosales
Cirujano General.2024; 46(3): 153. CrossRef - Lợi ích của siêu âm nội soi trước nội soi mật tụy ngược dòng trong chẩn đoán và điều trị bệnh lý tắc nghẽn đường mật tụy
Xuân Nguyễn
Journal of Clinical Medicine- Hue Central Hospital.2023;[Epub] CrossRef - Clinical safety and outcomes of glucagon use during endoscopic retrograde cholangiopancreatography (ERCP)
Abhilash Perisetti, Hemant Goyal, Neil Sharma
Endoscopy International Open.2022; 10(04): E558. CrossRef - Gallstone pancreatitis: general clinical approach and the role of endoscopic retrograde cholangiopancreatography
Shanker Kundumadam, Evan L. Fogel, Mark Andrew Gromski
The Korean Journal of Internal Medicine.2021; 36(1): 25. CrossRef - Training in endoscopic retrograde cholangio-pancreatography: a critical assessment of the broad scenario of training programs and models
Camilla Gallo, Ivo Boškoski, Maria Valeria Matteo, Beatrice Orlandini, Guido Costamagna
Expert Review of Gastroenterology & Hepatology.2021; 15(6): 675. CrossRef - Causes and Countermeasures of Difficult Selective Biliary Cannulation: A Large Sample Size Retrospective Study
Yang Liu, Wei Liu, Junbo Hong, Guohua Li, Youxiang Chen, Yong Xie, Xiaojiang Zhou
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(5): 533. CrossRef - Impact of mechanical simulator practice on clinical ERCP performance by novice surgical trainees: a randomized controlled trial
Wenbo Meng, Ping Yue, Joseph W. Leung, Haiping Wang, Xiyan Wang, Fangzhao Wang, Kexiang Zhu, Lei Zhang, Xiaoliang Zhu, Zhengfeng Wang, Hui Zhang, Wence Zhou, Xun Li
Endoscopy.2020; 52(11): 1004. CrossRef - Does melatonin addition to indomethacin decrease post endoscopic retrograde cholangiopancreatography pancreatitis? A randomized double-blind controlled trial
Amir Sadeghi, Mohammad Abbasinazari, Hamid Asadzadeh Aghdaei, Saeed Abdi, Behzad Hatami, Mehrnaz Rasoolinezhad, Shaghayegh Jamshidzadeh, Saeede Saadati
European Journal of Gastroenterology & Hepatology.2019; 31(11): 1350. CrossRef - Does rectal ketoprofen prevent post ERCP pancreatitis?
Elias Makhoul, Joe El Mir, Marc Harb
Arab Journal of Gastroenterology.2019; 20(3): 141. CrossRef - Colangiopancreatografía retrógrada endoscópica: indicaciones y procedimiento
Ángel Pichel Loureiro, Fátima Barcala del Caño, Beatriz Romero Mosquera, Javier Robles Fernández, Nerea Catarina Quintaáns Pinazas
FMC - Formación Médica Continuada en Atención Primaria.2018; 25(9): 529. CrossRef
- Variables endoscópicas pre procedimiento asociadas a canulación difícil en colangiopancreatografía retrógrada endoscópica en un hospital de referencia de Lima, Perú
- 7,590 View
- 254 Download
- 9 Web of Science
- 12 Crossref
Focused Review Series: EUS-Guided Therapeutic Interventions
- Endoscopic Ultrasound-Guided Pancreatic Duct Intervention
- Yuto Shimamura, Jeffrey Mosko, Christopher Teshima, Gary R May
- Clin Endosc 2017;50(2):112-116. Published online March 30, 2017
- DOI: https://doi.org/10.5946/ce.2017.046
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Abstract
PDFPubReaderePub
- Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is an emerging endoscopic approach allowing access and intervention to the pancreatic duct (PD) for patients with failed endoscopic retrograde pancreatography (ERP) or patients with surgically altered anatomy. As opposed to biliary drainage for which percutaneous drainage is an alternative following failed endoscopic retrograde cholangiopancreatography (ERCP), the treatment options after failed ERP are very limited. Therefore, endoscopic ultrasound (EUS)-guided access to the PD and options for subsequent drainage may play an important role as an alternative to surgical intervention. However, this approach is technically demanding with a high risk of complications, and should only be performed by highly experienced endoscopists. In this review, we describe an overview of the current endoscopic approaches, basic technical tips, and outcomes using these procedures.
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Citations
Citations to this article as recorded by- Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience
Joan B. Gornals, Albert Sumalla-Garcia, Daniel Luna-Rodriguez, Maria Puigcerver-Mas, Julio G. Velasquez-Rodriguez, Silvia Salord, Sandra Maisterra, Juli Busquets
Gastroenterología y Hepatología.2025; 48(2): 502221. CrossRef - Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience
Joan B. Gornals, Albert Sumalla-Garcia, Daniel Luna-Rodriguez, Maria Puigcerver-Mas, Julio G. Velasquez-Rodriguez, Silvia Salord, Sandra Maisterra, Juli Busquets
Gastroenterología y Hepatología (English Edition).2025; 48(2): 502221. CrossRef - EUS-guided pancreatic duct drainage: a single-center observational study
Elodie Romailler, Anouk Voutaz, Sarra Oumrani, Mariola Marx, Maxime Robert, Fabrice Caillol, Alain Schoepfer, Sébastien Godat
iGIE.2024; 3(2): 237. CrossRef - Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Schalk W. van der Merwe, Roy L. J. van Wanrooij, Michiel Bronswijk, Simon Everett, Sundeep Lakhtakia, Mihai Rimbas, Tomas Hucl, Rastislav Kunda, Abdenor Badaoui, Ryan Law, Paolo G. Arcidiacono, Alberto Larghi, Marc Giovannini, Mouen A. Khashab, Kenneth F.
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Roy L. J. van Wanrooij, Michiel Bronswijk, Rastislav Kunda, Simon M. Everett, Sundeep Lakhtakia, Mihai Rimbas, Tomas Hucl, Abdenor Badaoui, Ryan Law, Paolo Giorgio Arcidiacono, Alberto Larghi, Marc Giovannini, Mouen A. Khashab, Kenneth F. Binmoeller, Marc
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Tae Hyeon Kim, Hyung Ku Chon
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Mark J Radlinski, Daniel S Strand, Vanessa M Shami
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Zarak Khan, Umar Hayat, Sharareh Moraveji, DouglasG Adler, AliA Siddiqui
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Rupinder Mann, Umesha Boregowda, Neil Vyas, Mahesh Gajendran, Chandra Prakash Umapathy, Hari Sayana, Juan Echavarria, Sandeep Patel, Shreyas Saligram
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Ankit Dalal, Gaurav Patil, Amit Maydeo
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Se Woo Park, Sang Soo Lee
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Matthew R. Krafft, John Y. Nasr
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Patrick Pfau
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Li-Chang Hsing, Jinyoung Kim, Ha Il Kim, Jae Cheol Park, Jisoo Han, Jae Hyuck Jun, Myung-Hwan Kim
The Korean Journal of Medicine.2017; 92(6): 533. CrossRef
- Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience
- 8,149 View
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Case Reports
- Acute Ectopic Pancreatitis Occurring after Endoscopic Biopsy in a Gastric Ectopic Pancreas
- Seong Jun Lee, Gwang Ha Kim, Do Youn Park, Sang A Choi, Sang Hee Lee, Yu Yi Choi, Moo Song Jeon, Geun Am Song
- Clin Endosc 2014;47(5):455-459. Published online September 30, 2014
- DOI: https://doi.org/10.5946/ce.2014.47.5.455
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Abstract
PDFPubReaderePub
Ectopic pancreas is a congenital anomaly and the most common type of ectopic tissue in the gastrointestinal tract. Most patients with an ectopic pancreas are asymptomatic and rarely have complications. Ectopic pancreatitis after an endoscopic biopsy has not been reported. We report a patient who developed acute ectopic pancreatitis in the stomach after an endoscopic biopsy. A 71-year-old male patient presented with a subepithelial tumor (SET) in the stomach and had no symptoms. Endoscopic ultrasonography demonstrated a 30-mm hypoechoic mural mass, lobulated margins, and anechoic duct-like lesions. To obtain proper tissue specimen, endoscopic biopsy was performed through the opening on the surface of the mass. The pathologic results confirmed an ectopic pancreas. One day after the endoscopic biopsy, he developed persistent epigastric pain. His serum amylase and lipase elevated. Computed tomography of the abdomen showed swelling of the SET and diffuse edema of the gastric wall. His condition was diagnosed as acute ectopic pancreatitis occurring after endoscopic biopsy.
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Citations
Citations to this article as recorded by- Gastric outlet obstruction associated with gastric ectopic pancreas in children: Report of two cases
Chia-Wei Liu, Hsun-Chin Chao, Wan-Hsin Su
Pediatrics & Neonatology.2025; 66(1): 78. CrossRef - Gastric ectopic pancreas in magnetic resonance imaging: A review of 2 cases
Miguel Braga, António P. Matos, Pedro Pinto Marques, Miguel Ramalho
Radiology Case Reports.2023; 18(3): 1181. CrossRef - Clinicopathological features and management strategy for superficial nonampullary duodenal tumors: a multi-center retrospective study
Eun Young Kim, Dong Jin Kim, Han Hong Lee, Jun Hyun Lee, Jeong Goo Kim, Kyo Young Song, Jin Jo Kim, Hyung Min Chin, Wook Kim
Annals of Surgical Treatment and Research.2022; 102(5): 263. CrossRef - Pancreatitis in the developmentally anomalous pancreas
Cecil G. Wood, Camila Lopes Vendrami, Elizabeth Craig, Pardeep K. Mittal, Frank H. Miller
Abdominal Radiology.2020; 45(5): 1316. CrossRef - Minimally Invasive Management of Ectopic Pancreas
Gerardo A. Vitiello, Michael J. Cavnar, Cristina Hajdu, Inessa Khaykis, Elliot Newman, Marcovalerio Melis, H. Leon Pachter, Steven M. Cohen
Journal of Laparoendoscopic & Advanced Surgical Techniques.2017; 27(3): 277. CrossRef - Clinical picture: multiple sites of ectopic pancreatic tissue
J Straatman, R J Meester, N C T v. Grieken, M J A M Jacobs, P d. Graaf, G Kazemier, M A Cuesta
SpringerPlus.2015;[Epub] CrossRef
- Gastric outlet obstruction associated with gastric ectopic pancreas in children: Report of two cases
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- Extramedullary Plasmacytoma of the Pancreas Diagnosed Using Endoscopic Ultrasonography-Guided Fine Needle Aspiration
- Young Hoon Roh, Sang Youn Hwang, Seon-Mi Lee, Jung Woo Im, Joon Suk Kim, Kyeong A Kwon, Joo Yeon Song, Soo Yeong Jeong
- Clin Endosc 2014;47(1):115-118. Published online January 24, 2014
- DOI: https://doi.org/10.5946/ce.2014.47.1.115
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Abstract
PDFPubReaderePub
Extramedullary plasmacytoma involves organs outside the bone marrow; however, involvement of the pancreas is rare. We recently experienced a case of extramedullary plasmacytoma of the pancreas that was diagnosed by endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). EUS-FNA, which has a high diagnostic accuracy and an excellent safety profile, is the modality of choice for establishing tissue diagnosis. We report a case of extramedullary plasmacytoma of the pancreas diagnosed using EUS-FNA.
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Citations
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Asiya Tafader, Mahum Nadeem, Joseph Spataro
European Journal of Medical Case Reports.2024;[Epub] CrossRef - Incidental diagnosis of a rare pancreatic plasmacytoma with plasmablastic features
Sabah Iqbal, Shubham Agrawal, Krishna Desai, Mahati Paravathaneni, Rajesh Thirumaran
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S S Benbarka, P T Shubert, E M Irusen, B W Allwood, C F N Koegelenberg
African Journal of Thoracic and Critical Care Medicine.2022; : 167. CrossRef - Obstructive jaundice caused by pancreatic plasmacytoma secondary to multiple myeloma: A case report and literature review
Mei Lan Jiang, Zhi Jian Liu, Yin Zhu, Pi Liu, Yong Zhu, Xiao Jiang Zhou, Nong Hua Lv, Hui Fang Xiong
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Ján Csomor, Bohuš Bunganič, Dominika Dvořáková, Petr Hříbek, Klára Kmochová, Vít Campr, Inna Tučková, Cyril Šálek, Petr Urbánek, Miroslav Zavoral
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Xin Wang, Huaiya Xie, Lu Zhang
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Semra Paydas
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Shintaro KURAHASHI, Kenichi KOMAYA, Takaaki OSAWA, Norimitsu ISHII, Yuji KOBAYASHI, Tadahisa INOUE, Hideki MURAKAMI, Tsuyoshi SANO
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Tatsuya Utsumi, Junpei Sasajima, Takuma Goto, Shugo Fujibayashi, Tatsuya Dokoshi, Aki Sakatani, Kazuyuki Tanaka, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Yuhei Inaba, Junki Inamura, Motohiro Shindo, Kentaro Moriichi, Mikihiro Fujiya, Yutaka Kohgo
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- A case report on pancreatic plasmacytoma presenting as obstructive jaundice
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Original Article
- Endoscopic Ultrasound Elastography for the Pancreas in Korea: A Preliminary Single Center Study
- Tae Hee Lee, Young Deok Cho, Sang-Woo Cha, Joo Young Cho, Jae Young Jang, Soung Won Jeong, Hyun Jong Choi, Jong Ho Moon
- Clin Endosc 2013;46(2):172-177. Published online March 31, 2013
- DOI: https://doi.org/10.5946/ce.2013.46.2.172
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Abstract
PDFPubReaderePub
Background/Aims Endoscopic ultrasound elastography (EUS-EG) has been widely used for the evaluation of pancreatic cancer in the Western world. To date, there is very little experience with EUS-EG in Korea. We described the results of comparison between normal pancreas and pancreatic cancer in Korea.
Methods The present study was performed at a tertiary hospital on 35 subjects comprising 20 with normal pancreas (control group) and 15 with pancreatic cancer (disease group). We compared the EUS-EG performance of the two groups.
Results The pancreas in the control group showed a mean elasticity value of 0.53% (95% confidence interval [CI], 0.45 to 0.61). The elasticity value was higher than that previously reported from Western country (0.47%; 95% CI, 0.38 to 0.57). In the disease group, the mean elasticity value of pancreatic lesions was 0.02% (95% CI, 0.01 to 0.02). The mean elasticity value of the disease group was significantly lower than that of the control group (
p <0.0001).Conclusions EUS-EG could be a highly sensitive diagnostic modality for pancreatic cancer in Korea with little EUS-EG experience. We also provided the reference range of elasticity value of normal pancreas, which might be valuable in the interpretation of pancreatic elasticity data for Korean adults.
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Citations
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Mostafa Alnoury, Hashim R. Mehdi, Atif Zaheer
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Takamichi KUWAHARA, Kazuo HARA, Nobumasa MIZUNO, Shin HABA, Nozomi OKUNO
Choonpa Igaku.2022; 49(3): 275. CrossRef - Recent Advances in Endosonography—Elastography: Literature Review
Akira Yamamiya, Atsushi Irisawa, Koki Hoshi, Akane Yamabe, Naoya Izawa, Kazunori Nagashima, Takahito Minaguchi, Masamichi Yamaura, Yoshitsugu Yoshida, Ken Kashima, Yasuhito Kunogi, Fumi Sakuma, Keiichi Tominaga, Makoto Iijima, Kenichi Goda
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Valeria Tonini, Manuel Zanni
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Nan Ge, Si-Yu Sun
World Journal of Clinical Cases.2020; 8(9): 1729. CrossRef - Present status of ultrasound elastography for the diagnosis of pancreatic tumors: review of the literature
Takamichi Kuwahara, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Nozomi Okuno
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Masayuki Kitano, Takeichi Yoshida, Masahiro Itonaga, Takashi Tamura, Keiichi Hatamaru, Yasunobu Yamashita
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Aatur D. Singhi, Eugene J. Koay, Suresh T. Chari, Anirban Maitra
Gastroenterology.2019; 156(7): 2024. CrossRef - Diagnostic Efficacy of Endoscopic Ultrasound Elastography in Differentiating Solid Pancreatic Lesions: A Single-Center Experience
Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy
Clinical Endoscopy.2019; 52(4): 360. CrossRef - Elastography of the Pancreas, Current View
Christoph F. Dietrich, Michael Hocke
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Binglan Zhang, Fuping Zhu, Pan Li, Shishi Yu, Yajing Zhao, Minmin Li
Pancreatology.2018; 18(7): 833. CrossRef - Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in differentiating malignant from benign pancreatic lesions?
Hussein Hassan Okasha, Reem Ezzat Mahdy, Shaimaa Elkholy, Mohamed Sayed Hassan, Ahmed Nabil El-Mazny, Kareem Essam Eldin Hadad, Moustafa Saeed, Mohamed El-Nady, Osama Soliman Elbalky, Asem Ashraf, Amr Abo El-Magd, Abeer Awad
Medicine.2018; 97(36): e11689. CrossRef - Differentiation of Pancreatic Masses via Endoscopic Ultrasound Strain Ratio Elastography Using Adjacent Pancreatic Tissue as the Reference
Nadan Rustemović, Mirjana Kalauz, Katja Grubelić Ravić, Hrvoje Iveković, Branko Bilić, Zvonimir Ostojić, Dalibor Opačić, Iva Ledinsky, Matea Majerović, Ana Višnjić
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Tanyaporn Chantarojanasiri, Pradermchai Kongkam
World Journal of Gastrointestinal Endoscopy.2017; 9(10): 506. CrossRef - New Imaging Techniques
Julio Iglesias-García, Jose Lariño-Noia, Juan Enrique Domínguez-Muñoz
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Andrada Seicean, Ofelia Mosteanu, Radu Seicean
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Special Issue Articles of IDEN 2012
- Endoscopic Necrosectomy for Walled-Off Pancreatic Necrosis
- Michel Kahaleh
- Clin Endosc 2012;45(3):313-315. Published online August 22, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.3.313
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Abstract
PDFPubReaderePub
Approximately 20% of patients with acute pancreatitis develop pancreatic necrosis with significant mortality. Surgical debridement is the traditional management of necrotizing pancreatitis, but it is associated with significant morbidity and mortality. Endoscopic necrosectomy using repeats session of debridement and stent insertion has been more frequently used within the last decade and half. This technique continues to evolve as we attempt to optimize the post-procedural outcomes.
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Citations
Citations to this article as recorded by- Wernicke Encephalopathy after Endoscopic Necrosectomy in Acute Necrotizing Pancreatitis with WOPN: A Case Report
Minsu Kim, Eun Kyung Kang, Su Young Kim, Ji-Yeon Kim, Song Mi Moon, Yiel-Hea Seo, Jae Hee Cho, Yoon Soo Park
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Hiroyuki Isayama, Yousuke Nakai, Rungsun Rerknimitr, Christopher Khor, James Lau, Hsiu‐Po Wang, Dong Wan Seo, Thawee Ratanachu‐ek, Sundeep Lakhtakia, Tiing Leong Ang, Shomei Ryozawa, Tsuyoshi Hayashi, Hiroshi Kawakami, Natusyo Yamamoto, Takuji Iwashita, F
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Case Report
- Ectopic Pancreas Bleeding in the Jejunum Revealed by Capsule Endoscopy
- Mi-Jeong Lee, Jae Hyuck Chang, Il Ho Maeng, Jin Young Park, Yun Sun Im, Tae Ho Kim, Sok-Won Han, Do Sang Lee
- Clin Endosc 2012;45(3):194-197. Published online August 22, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.3.194
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Abstract
PDFPubReaderePub
Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location. It is often found incidentally at different sites in the gastrointestinal (GI) tract. The incidence of ectopic pancreatic tissue in autopsy series is 1% to 2%, with 70% of the ectopic lesions found in the stomach, duodenum and jejunum. Although it is usually a silent anomaly, an ectopic pancreas may become clinically evident when complicated by inflammation, bleeding, obstruction or malignant transformation. We report a case of ectopic pancreas located in the jejunum and presenting as an obscure GI bleeding, which was diagnosed by capsule endoscopy.
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Citations
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Xiaofeng Yang, Chen Liu, Shuai Sun, Chao Dong, Shanshan Zhao, Zaitun M. Bokhary, Na Liu, Jinghua Wu, Guojian Ding, Shisong Zhang, Lei Geng, Hongzhen Liu, Tingliang Fu, Xiangqian Gao, Qiong Niu
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Masanari Sekine, Takeharu Asano, Hirosato Mashima
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Focused Review Series: What Should We Know about EUS-FNA?
- Endoscopic Ultrasound-Guided Fine Needle Aspiration in Cystic Pancreatic Lesions
- Robert H. Hawes, James Clancy, Muhammad K. Hasan
- Clin Endosc 2012;45(2):128-131. Published online June 30, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.2.128
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Abstract
PDFPubReaderePub
Incidental pancreatic cysts are being increasingly recognized recently with incremented concern about health and frequent health check-up. Endoscopic ultrasound (EUS) has emerged as the principal modality for imaging pancreas for various pancreatic diseases including pancreatic cyst. But imaging alone cannot accurately identify the exact nature of the pancreatic cyst. EUS-guided fine needle aspiration is a useful adjunctive procedure to differentiate pancreatic cystic lesions. Cystic fluid analysis with cytologic evaluation is important to diagnose etiology of pancreatic cystic lesions, helping the clinician to more accurately assess the presence or potential for malignancy.
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Citations
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Rudy El Asmar, Nazih Bizri, Nikhil Vaishnav Tirukkovalur, Adam Tcharni, Navya Dasyam, Samer AlMasri
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- Heterotopic Pancreas of the Jejunum Identified by Capsule Endoscopy
- Si Eun Kong, M.D., Chang Nyol Paik, M.D., Eun Jung Kim, M.D., Hyung Jin Kim, M.D.*, Ji Han Jung, M.D.†, Woo Chul Chung, M.D., Kang Moon Lee, M.D. and Jin Mo Yang, M.D.
- Korean J Gastrointest Endosc 2011;42(4):259-262. Published online April 28, 2011
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- Heterotopic pancreas is an uncommon condition that commonly occurs in the gastrointestinal tract such as the stomach and small bowel. It is defined as the presence of pancreatic tissue outside its usual location and lacking anatomical and vascular continuity with the pancreas. A heterotopic pancreas is usually found incidentally and is mostly silent; however, it rarely causes abdominal pain, weight loss, bleeding, or ileus. A 49-year-old male presented with intermittent abdominal pain for 4 weeks. We report a case with submucosal features of a jejunal heterotopic pancreas with the aid of capsule endoscopy and a histological confirmation through a single port laparoscopic segmental jejunectomy. (Korean J Gastrointest Endosc 2011;42:259-262)
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- A Case of Mucinous Cystic Neoplasm of the Pancreas Communicating with the Main Pancreatic Duct
- Jae Jin Hwang, M.D., Tae Hyo Kim, M.D., Wan Su Kim, M.D., Hyeoun Jung Jang, M.D., Hong Jun Kim, M.D., Hyun Jin Kim, M.D., Woon Tae Jung, M.D. and Ok Jae Lee, M.D.
- Korean J Gastrointest Endosc 2010;41(5):324-327. Published online November 30, 2010
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- Diagnoses of cystic lesions in the pancreas are increasing in clinical practice because of the wider use of imaging studies. The selection of appropriate treatment depends on the ability to distinguish between benign and malignant cysts. However, cystic pancreatic neoplasms are sometimes misdiagnosed as pseudocysts and treated improperly. We experienced a case of mucinous cystic neoplasm of the pancreas misdiagnosed as a pseudocyst, which had a communication between the cyst and the main pancreatic duct. (Korean J Gastrointest Endosc 2010;41:324-327)
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- A Case of Successful Endoscopic Treatment for Acute Recurrent Pancreatitis Due to Pancreas Divisum with Santorinicele Masquerading as Drug Induced Pancreatitis
- Yun Suk Shim, M.D., Tae Hoon Lee, M.D., Jun Ho Choi, M.D., Sang Pil Kim, M.D., Sae Hwan Lee, M.D., Il Kwun Chung, M.D., Sang Heum Park, M.D. and Sun Joo Kim, M.D.
- Korean J Gastrointest Endosc 2010;40(2):139-143. Published online February 27, 2010
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- There are various causes of acute pancreatitis, and accurately determining the etiology is pivotal for selecting appropriate management. Other hidden causes, such as congenital anomaly, should be considered in patients with recurrent abdominal pain or unexplained recurrent pancreatitis. A santorinicele is a focal cystic dilatation of the terminal dorsal pancreatic duct, and this is usually associated with pancreas divisum and it is a risk factor for acute pancreatitis due to the accompanying relative stenosis of the minor papilla. We present here the case of a patient who was treated for acute pancreatitis that was presumably was caused by either Rifampin or Brucellosis, and the patient recovered with conservative management. However, we eventually diagnosed pancreas divisum with santorinicele by performing MRCP and ERCP after the pancreatitis had relapsed. We report here on a case of successful endoscopic treatment for pancreas divisum with santorinicele as a cause of recurrent pancreatitis, and this was initially confused with drug or infection related pancreatitis. (Korean J Gastrointest Endosc 2009; 40:139-143)
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- A Case of Pancreatic Dual Wirsung Ducts in a Patient with von Hippel-Lindau Disease
- Hye Soo Kim, M.D., Byung Hoon Han, M.D., Sun Jung Kim, M.D., Jee Sook Lee, M.D., Sae Jin Park, M.D., Sang Uk Lee, M.D., Bang Hur, M.D.* and Jung Hyun Kim, M.D.†
- Korean J Gastrointest Endosc 2008;37(5):384-388. Published online November 30, 2008
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- Rare autosomal dominant disorders associated with various tumors and cysts, and several kinds of pancreatic lesions have been described in patients with von Hippel- Lindau (VHL) disease, but there have been few studies concerned with the variations of the pancreatic duct. We experienced a case of pancreatic dual Wirsung ducts in a patient with VHL disease. Computed tomography scans showed that multiple cysts had nearly completely replaced the pancreas, there was a solid tumor on the uncinate process of the pancreas and a left renal mass suggested renal cell carcinoma. ERCP shows that the Santorini duct and Wirsung duct were fused in a normal fashion, and another Wirsung duct had shrub-like branches that are commonly seen in pancreatic divisum. (Korean J Gastrointest Endosc 2008;37:384-388)
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- A Case of Complete Agenesis of the Dorsal Pancreas
- Sun Jung Kim, M.D., Byung Hoon Han, M.D., Hyun Joo Jung, M.D., Hong Jun You, M.D., Sung Woo Yang, M.D., Se Young Park, M.D. and Sang Uk Lee, M.D.
- Korean J Gastrointest Endosc 2008;36(4):252-255. Published online April 30, 2008
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- The pancreas with the complete absence of its body and tail is the result of underdevelopment or agenesis of the dorsal pancreatic bud during embryogenesis, and this is a rare anomaly. We report here on a case of a 38-year-old man who had a pancreas with the total absence of the body and tail. On the abdominal computed tomography (CT), only a pancreatic head portion with speckled calcifications was seen, and the pancreatic body and tail were not visualized at all. Endoscopic retrograde cholangiopancreatography (ERCP) showed only a short major pancreatic duct with smooth tapering and terminal arborization. The Ampulla of Vater had a normal appearance and it was located at the medial side of the second portion of the duodenum. There was no difficulty to perform cannulation. Any minor papilla was not found. On magnetic resonance cholangiopancreatography (MRCP), the duct of Santorini and the duct in the body and tail were not visualized. (Korean J Gastrointest Endosc 2008;36:252-256)
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- A Case of Pancreatic Arteriovenous Malformation Presenting Upper Gastrointestinal Bleeding
- Su Hee Park, M.D., Mi Jeong Kim, M.D., You Sang Ko, M.D., You Jin Lim, M.D., Seung Yong Han, M.D., Hyun Woo Byun, M.D., Min Ho Choi, M.D., Hyun Joo Jang, M.D., Sea Hyub Kye, M.D. and Jin Lee, M.D.
- Korean J Gastrointest Endosc 2007;35(5):359-363. Published online November 30, 2007
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- A pancreatic arteriovenous malformation (AVM) is a very rare disease entity that is usually asymptomatic; however, it may present with a massive gastrointestinal hemorrhage. Recent advances in cross-sectional imaging and the widespread availability of angiography have contributed to the diagnosis of this condition. A patient was transferred to our clinic due to unknown origin gastrointestinal bleeding and upper abdominal pain. Double balloon enteroscopy and duodenoscopy revealed a bleeding pancreatico-cholangio-duodenal fistula. We were able to diagnose an arteriovnous malformation with a pancreatico- cholangio-duodenal fistula by the use of angiography and from the post-operative pathological findings. (Korean J Gastrointest Endosc 2007;35:359-363)
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- Endoscopic Removal of a Severed, Impacted Lithotomy Basket in the Pancreatic Duct in a Patient with Pancreas Divisum -Endoscopic Removal of Severed, Impacted Basket-
- Soo Jung Park, M.D., Sung Koo Lee, M.D., Jeung Hye Han, M.D., Kyung Uk Jo, M.D., Sang Soo Lee, M.D., Dong Wan Seo, M.D. and Myung-Hwan Kim, M.D.
- Korean J Gastrointest Endosc 2007;34(5):286-290. Published online May 30, 2007
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- Therapeutic endoscopy in patients with pancreas divisum has continued to evolve with the availability of minor papilla endoscopic sphincterotomy, stenting, or sphinteroplasty. A combination of a sphincterotomy followed by balloon/basket deployment and emergency mechanical lithotripsy had facilitated the removal of impacted or large stones in the pancreatic and biliary ducts. The impaction of the basket with captured stones or rupture of the basket traction-wire during mechanical lithotripsy are rare complications. We report the successful retrieval of a center-severed and impacted lithotomy basket in the duct of Santorini in a 47-year-old patient with pancreas divisum. Endobiliary biopsy forceps were introduced into minor papilla, the basket was drawn and the stone was removed successfully after 2 months. To the best of our knowledge, this is a first report of the removal of a center-severed and impacted lithotomy basket in the pancreatic duct. (Korean J Gastrointest Endosc 2007;34:286290)
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- Two Cases of Endoscopic Resection of Submucosal Tumor of the Minor Papilla
- Yong Ho Choi, M.D., Do Hyun Park, M.D., Seong Jun Kim, M.D., Meong Jin Kang, M.D., Hyun Deuk Jo, M.D.*, Mee Hye Oh, M.D.*, Jeong Hoon Park, M.D., Suck Ho Lee, M.D., Hong Soo Kim, M.D., Sang Heum Park, M.D. and Sun Joo Kim, M.D.
- Korean J Gastrointest Endosc 2007;34(3):164-169. Published online March 30, 2007
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- Tumors of the minor papilla are very rare and these tumors have generally been known as neuroendocrine tumors such as carcinoid tumor and somatostatinoma. As these are mostly submucosal tumors, their diagnosis is difficult by just performing endoscopic forceps biopsy, but diagnosis is possible by surgery or endoscopic resection. EUS and ERCP is an essential tool for the diagnosis of these tumors, and abdominal CT or MRI is also useful because there is the possibility of malignant tumors such as carcinoid tumor. For our present two cases, screening endoscopy revealed the polypoid lesion of the minor papilla. EUS disclosed that the submucosal tumor was limited to the submucosal layer and no abnormality was found from the abdominal CT and ERCP. Herein, we performed endoscopic resection for making the diagnosis and treatment. Histologically, these 2 tumors were diagnosed as ectopic pancreas and gangliocytic paraganglioma, respectively. (Korean J Gastrointest Endosc 2007;34:164-169)
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- A Case of Pancreatogastric Fistula Associated with Intraductal Papillary Mucinous Neoplasm
- Seung Geun Lee, M.D., Il Du Kim, M.D., Hye Jeong Lee, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D., Jee Yeon Kim, M.D.* and Suk Kim, M.D.†
- Korean J Gastrointest Endosc 2006;33(4):257-260. Published online October 30, 2006
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- There have been an increasing number of reports of intraductal papillary mucinous neoplasm (IPMN) of the pancreas since its first report by Ohhasi et al. in 1982. However, fistula formation associated with IPMN to other organs is rare. A 79-year -old woman visited our hospital due to diarrhea and dyspepsia for 3 months. Abdominal computed tomography and magnetic resonance imaging revealed IPMN of the pancreas and fistula formation in the stomach. Endoscopic retrograde cholangiography after injecting a dye through the pancreatic duct showed dye flowing out into stomach. An endoscopic biopsy was carried out through the pancreatogastric fistula and this tumor was confirmed to be IPMN. We report a case of pancreatogastric fistula associated with IPMN that was confirmed by histology. (Korean J Gastrointest Endosc 2006;33:257261)
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- A Case of Gastric Ectopic Pancreas Complicated by Chronic Pancreatitis
- Seung Hyun Jung, M.D., Euyi Hyeog Im, M.D., Yong Moon Kim, M.D., Sun Moon Kim, M.D., Tae Hee Lee, M.D., Kyu Chan Huh, M.D., Young Woo Choi, M.D., Young Woo Kang, M.D., Hyoun Sik Min, M.D.* and Beom Kyoung Kim, M.D.†
- Korean J Gastrointest Endosc 2006;32(6):409-412. Published online June 30, 2006
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- An ectopic pancreas is defined as the presence of pancreatic tissue lacking the anatomical and vascular continuity of the main body of the pancreas. Most cases of ectopic pancreas are found incidentally in the stomach and duodenum. The most commonly reported symptoms are abdominal pain, epigastric discomfort, nausea, vomiting and bleeding. An ectopic pancreas is subject to various pathological changes occurring in the pancreas itself: namely, cyst, pancreatitis, hemorrhage, necrosis and neoplastic changes. We report a case of a 28-year old man with epigastric pain in whom the surgical pathological diagnosis was an ectopic pancreas of the stomach with chronic inflammation. (Korean J Gastrointest Endosc 2006;32:409413)
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- Upper Gastrointestinal Bleeding Due to Gastric Ectopic Pancreas in a Young Aged Person
- Jung Won Yun, M.D., Young Bum Park, M.D., Um Seok Lee, M.D., Choong Hyeon Lee, M.D., Dal Yeon Won, M.D.*, Ji Hoon Kim, M.D.† and Jae Min Song, M.D.‡
- Korean J Gastrointest Endosc 2006;32(2):132-135. Published online February 27, 2006
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- An ectopic pancreas is the presence of pancreatic tissue outside of its usual location. This condition rarely causes clinical symptoms, and the most commonly reported sites of these lesions are the stomach, the duodenum and jejunum. The presence of this ectopic tissue is not a rare condition, but its unusual locations, clinical symptoms, and complications are of clinical interest. We report a case of a gastric ectopic pancreas with recurrent upper gastrointestinal bleeding in a 20-year-old man. (Korean J Gastrointest Endosc 2006;32:132135)
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- Can EUS Help to Differentiate Macrocystic Serous Cystadenoma from Mucinous Cystadenoma of the Pancreas by Its Morphologic Characteristics?
- Seok Won Jung, M.D., Sang Soo Lee, M.D., Kyu Pyo Kim, M.D., Moon Hee Song, M.D., Jimin Han, M.D., Jong Cheol Kim, M.D., Eun Kwang Choi, M.D., Young Min Joo, M.D., Dong Wan Seo, M.D., Sung Koo Lee, M.D., Myung-Hwan Kim, M.D. and Se Jin Jang, M.D.*
- Korean J Gastrointest Endosc 2006;32(2):109-115. Published online February 27, 2006
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- Background
/Aims: A macrocystic variant of a serous cystadenoma (M-SCA) is usually indistinguishable from a mucinous cystadenoma (MCA) as a result of their morphologic similarity on conventional imaging studies. However, a MCA requires a resection due to its malignant potential. The aim of this study was to determine the EUS morphological characteristics of a M-SCA to determine if they could be used to help differentiate it from MCA. Methods: The clinical and EUS morphologic characteristics were examined in 31 consecutive patients with M-SCA and MCA who underwent surgery. Results: Resected specimens were available from 11 M-SCAs and 20 MCAs. Significant differences were observed with regard to the age and location within the pancreas. On EUS, most of the M-SCA contained microcysts (82%) compared with only 15% of MCA cases, and a lobulated configuration of the cyst was observed more frequently in the M-SCA cases than in the MCA (91% vs. 25%). The combination of microcysts and the lobulated configuration of the cysts had a 100% specificity and positive predictive value for differentiating M-SCA from MCA. Conclusions: M-SCA tends to occur at a relatively younger age than MCA, and is located mainly in the head of the pancreas. Although there is considerable morphological similarity between M-SCA and MCA on the conventional imaging modalities, the morphological characteristics obtained from EUS including microcysts with a lobulated configuration may help to make a distinction between M-SCA and MCA. (Korean J Gastrointest Endosc 2006;32:109115)
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- A Case of Intraductal Papillary Mucinous Tumor of the Pancreas with Scant Mucin Production
- Won Jae Yoon, M.D., Jun Kyu Lee, M.D., Kwang Hyuck Lee, M.D., Ji Kon Ryu, M.D., Yong-Tae Kim, M.D. and Yong Bum Yoon, M.D.
- Korean J Gastrointest Endosc 2005;31(3):204-208. Published online September 30, 2005
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- Intraductal papillary mucinous tumors of the pancreas (IPMT) commonly produce large amount of mucin. However, rare cases of IPMTs with scant mucin production were reported. Although such tumors seem to produce little or no mucin at all, immunohistochemical staining usually reveals the histologic evidence of mucin production. We report a case of intraductal papillary mucinous tumor of the pancreas with scant mucin production. (Korean J Gastrointest Endosc 2005;31:204209)
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- A Case of Intraductal Papillary Mucinous Tumor of the Pancreas with Scant Mucin Production
- Won Jae Yoon, M.D., Jun Kyu Lee, M.D., Kwang Hyuck Lee, M.D., Ji Kon Ryu, M.D., Yong-Tae Kim, M.D. and Yong Bum Yoon, M.D.
- Korean J Gastrointest Endosc 2005;31(3):204-208. Published online September 30, 2005
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- Intraductal papillary mucinous tumors of the pancreas (IPMT) commonly produce large amount of mucin. However, rare cases of IPMTs with scant mucin production were reported. Although such tumors seem to produce little or no mucin at all, immunohistochemical staining usually reveals the histologic evidence of mucin production. We report a case of intraductal papillary mucinous tumor of the pancreas with scant mucin production. (Korean J Gastrointest Endosc 2005;31:204209)
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- Three Cases of Santorinicele without Pancreas Divisum
- Ran Song, M.D., Kwang Ro Joo, M.D., Jae Young Jang, M.D., Ki Duk Nam, M.D., Nam Hoon Kim, M.D., Sang Kil Lee, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byoung-Ho Kim, M.D., Young-Woon Chang, M.D., Joung Il Lee, M.D. and Rin Chang, M.D.
- Korean J Gastrointest Endosc 2005;30(6):350-353. Published online June 30, 2005
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- Santorinicele is defined as a focal cystic dilatation of the terminal portion of the dorsal pancreatic duct at the minor papilla. It is unclear whether a santorinicele is congenital or an acquired lesion secondary to relative obstruction and a weakness of the distal dorsal duct wall. Because almost all santorinicele reported to date have been associated with pancreas divisum, it has been assumed that santorinicele is related to the obstruction of pancreatic outflow and resultant pancreatitis that occurs in the pancreas divisum. We describe three cases of santorinicele without pancreatic divisum which were identified incidentally. (Korean J Gastrointest Endosc 2005;30:350354)
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- A Case of Acute Pancreatitis Caused by Santorinicele with Incomplete Pancreas Divisum
- Dong Won Lee, M.D., Dong Yup Ryu, M.D., Bo Hyun Kim, M.D., Jung Sup Kim, M.D., Young Eun Park, M.D., Seong Hun Lee, M.D., Tae Oh Kim, M.D., Suk Kim, M.D.*, Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D. and Mong Cho, M.D.
- Korean J Gastrointest Endosc 2005;30(4):230-233. Published online April 30, 2005
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- A focal cystic dilatation of the terminal portion of the dorsal pancreatic duct at the minor papilla, termed "santorinicele", is seen in a small number of patients with pancreas divisum. Santorinicele is believed to result from a combination, either acquired or congenital, of relative obstruction and weakness of the distal ductal wall and has been suggested as a possible cause of relative stenosis of the accessory papilla, a risk factor for pancreatitis. We report a case of santorinicele associated with incomplete pancreas divisum, found in a 68-year-old woman presented with acute pancreatitis with a brief review of the literatures. (Korean J Gastrointest Endosc 2005;30:230234)
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