Pancreatoscopy-Guided Endotherapies for Pancreatic Diseases

Gastrointest Endosc Clin N Am. 2024 Jul;34(3):417-431. doi: 10.1016/j.giec.2024.02.007. Epub 2024 Apr 10.

Abstract

Per-oral pancreatoscopy (POP) is a pancreas-preserving modality that allows for targeted pancreatic duct interventions, particularly in cases where standard techniques fail. POP specifically has an emerging role in the diagnosis, risk stratification, and disease extent determination of main duct intraductal papillary mucinous neoplasms (IPMNs). It has also been successfully used for laser ablation of IPMNs in poor surgical candidates, lithotripsy for complex stone disease, and laser stricturoplasty. As experience with POP increases beyond select referral center practices, further studies validating POP efficacy with long-term follow-up will help clarify when POP-guided intervention is most beneficial in relation to surgical intervention.

Keywords: Cholangioscopy; Dilated pancreatic duct; Intraductal papillary mucinous neoplasm; Lithotripsy; Pancreatic duct stone; Pancreatic duct stricture; Pancreatoscopy; Stricturoplasty.

Publication types

  • Review

MeSH terms

  • Endoscopy, Digestive System / methods
  • Humans
  • Pancreatic Diseases* / surgery
  • Pancreatic Diseases* / therapy
  • Pancreatic Ducts / pathology
  • Pancreatic Ducts / surgery
  • Pancreatic Intraductal Neoplasms / surgery
  • Pancreatic Intraductal Neoplasms / therapy
  • Pancreatic Neoplasms / surgery
  • Pancreatic Neoplasms / therapy