Korean Journal of Gastrointestinal Endoscopy 1996;16(5): 733-741.
원저 : 담도 췌장 ; 췌장질환의 진단에 있어 초미세 췌관경 검사 ( Ultrathin - caliber Pancreatoscopy ) 의 유용성 ( Original Articles : Biliary Tract & Pancreas ; Clinical Usefulness of Ultrathin - caliber Pancreatoscopy on Diagnosis of Various Pancreatic Diaeases )
심찬섭, 이준성, 이문성, 조주영, 조영덕, 이영홍, 김연수, 황성규, 김진오, 봉형근 (Chan Sup Shim, Joon Seong Lee, Moon Sung Lee, Joo Young Cho, Young Deok Cho, Young Hong Lee, Yun Soo Kim, Seong Gyu Hwang, Hyung Keun Bong and Jin Oh Kim)
Abstract
Although ERCP has been widely used to diagnose and occasionally treat chronic pancreatitis, it is not always easy to differentiate between malignancy and benign disease by ERCP alone. So peroral pancreatoscopy(PPS) using mother and baby type scopes was developed and several types of peroral pancreatoscopes with various diameters have been used at several institutes. To assess the clinical usefulness of ultrathin-caliber pancreatoscopy on diagnosis of various pancreatic diseases, we performed peroral pancreatoscopy with PF 8P (Olympus, external diameter: 0.8 mm) in 12 cases(6 cases of chronic pancreatitis, 5 cases of pancreatic tumor, and 1 case of mucinous ductal ectasia) of pancreatic diseases. The pancreatoscope was successfully inserted into main pancreatic duct in 11 cases and permitted satisfactory endoscopic observation. The endoscopic findings of chronic pancreatitis were smooth stenosis, protein plug, and stones in pancreatic duct. Peroral pancreatoscopic findings of pancreatic cancer were characteristically seen as stenosis with irregular mucosal protrusion. In the mucin-producing tumor cases, the lesions were generally not clearly visualized due to the presence of copious amount of mucin. We conclude that pancreatoscopy is a valuable alternative or supplementary procedure to diagnostic imaging method of arriving at a more definite diagnosis in difficult cases. But several limitations, such as poor visual field, absence of biopsy channel and controllable tip, and poor durability of endoscope will be overcomed to serve as essential diagnosic tool for pancratic diseases. (Korean J Gastrointest 16: 733~739, 1996)
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