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The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis

Background  Confirming the diagnosis, invasiveness, and disease extent of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas is challenging. The aim of this study was to summarize the literature on the efficacy and safety of peroral pancreatoscopy (POP) in the diagnosis of IPMN, includ...

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Autores principales: de Jong, David M., Stassen, Pauline M. C., Groot Koerkamp, Bas, Ellrichmann, Mark, Karagyozov, Petko I., Anderloni, Andrea, Kylänpää, Leena, Webster, George J. M., van Driel, Lydi M. J. W., Bruno, Marco J., de Jonge, Pieter J. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767751/
https://www.ncbi.nlm.nih.gov/pubmed/35668651
http://dx.doi.org/10.1055/a-1869-0180
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author de Jong, David M.
Stassen, Pauline M. C.
Groot Koerkamp, Bas
Ellrichmann, Mark
Karagyozov, Petko I.
Anderloni, Andrea
Kylänpää, Leena
Webster, George J. M.
van Driel, Lydi M. J. W.
Bruno, Marco J.
de Jonge, Pieter J. F.
author_facet de Jong, David M.
Stassen, Pauline M. C.
Groot Koerkamp, Bas
Ellrichmann, Mark
Karagyozov, Petko I.
Anderloni, Andrea
Kylänpää, Leena
Webster, George J. M.
van Driel, Lydi M. J. W.
Bruno, Marco J.
de Jonge, Pieter J. F.
author_sort de Jong, David M.
collection PubMed
description Background  Confirming the diagnosis, invasiveness, and disease extent of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas is challenging. The aim of this study was to summarize the literature on the efficacy and safety of peroral pancreatoscopy (POP) in the diagnosis of IPMN, including the impact of pre- and intraoperative POP on the management of IPMN. Methods  The EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar databases were systematically searched for articles. Eligible articles investigated cohorts of patients who underwent POP for (suspected) IPMN. Results  25 articles were identified and included in this review; with 22 of these reporting on the diagnostic yield of POP in IPMN and 11 reporting on the effect of pre- or intraoperative POP on clinical decision-making. Cannulation and observation rates, and overall diagnostic accuracy were high across all studies. Frequently reported visual characteristics of IPMN were intraductal fish-egg-like lesions, hypervascularity, and granular mucosa. Overall, the adverse event rate was 12 %, primarily consisting of post-endoscopic retrograde cholangiopancreatography pancreatitis, with a pooled rate of 10 %, mostly of mild severity. Regarding the impact of POP on clinical decision-making, POP findings altered the surgical approach in 13 %–62 % of patients. Conclusion  POP is technically successful in the vast majority of patients with (suspected) IPMN, has a consistently high diagnostic accuracy, but an adverse event rate of 12 %. Data on intraoperative pancreatoscopy are scarce, but small studies suggest its use can alter surgical management. Future studies are needed to better define the role of POP in the diagnostic work-up of IPMN.
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spelling pubmed-97677512022-12-21 The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis de Jong, David M. Stassen, Pauline M. C. Groot Koerkamp, Bas Ellrichmann, Mark Karagyozov, Petko I. Anderloni, Andrea Kylänpää, Leena Webster, George J. M. van Driel, Lydi M. J. W. Bruno, Marco J. de Jonge, Pieter J. F. Endoscopy Background  Confirming the diagnosis, invasiveness, and disease extent of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas is challenging. The aim of this study was to summarize the literature on the efficacy and safety of peroral pancreatoscopy (POP) in the diagnosis of IPMN, including the impact of pre- and intraoperative POP on the management of IPMN. Methods  The EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar databases were systematically searched for articles. Eligible articles investigated cohorts of patients who underwent POP for (suspected) IPMN. Results  25 articles were identified and included in this review; with 22 of these reporting on the diagnostic yield of POP in IPMN and 11 reporting on the effect of pre- or intraoperative POP on clinical decision-making. Cannulation and observation rates, and overall diagnostic accuracy were high across all studies. Frequently reported visual characteristics of IPMN were intraductal fish-egg-like lesions, hypervascularity, and granular mucosa. Overall, the adverse event rate was 12 %, primarily consisting of post-endoscopic retrograde cholangiopancreatography pancreatitis, with a pooled rate of 10 %, mostly of mild severity. Regarding the impact of POP on clinical decision-making, POP findings altered the surgical approach in 13 %–62 % of patients. Conclusion  POP is technically successful in the vast majority of patients with (suspected) IPMN, has a consistently high diagnostic accuracy, but an adverse event rate of 12 %. Data on intraoperative pancreatoscopy are scarce, but small studies suggest its use can alter surgical management. Future studies are needed to better define the role of POP in the diagnostic work-up of IPMN. Georg Thieme Verlag KG 2022-07-20 /pmc/articles/PMC9767751/ /pubmed/35668651 http://dx.doi.org/10.1055/a-1869-0180 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle de Jong, David M.
Stassen, Pauline M. C.
Groot Koerkamp, Bas
Ellrichmann, Mark
Karagyozov, Petko I.
Anderloni, Andrea
Kylänpää, Leena
Webster, George J. M.
van Driel, Lydi M. J. W.
Bruno, Marco J.
de Jonge, Pieter J. F.
The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title_full The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title_fullStr The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title_full_unstemmed The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title_short The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
title_sort role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767751/
https://www.ncbi.nlm.nih.gov/pubmed/35668651
http://dx.doi.org/10.1055/a-1869-0180
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