Systematic Reviews
Copyright ©The Author(s) 2019.
World J Gastrointest Endosc. Feb 16, 2019; 11(2): 155-167
Published online Feb 16, 2019. doi: 10.4253/wjge.v11.i2.155
Table 1 Per oral pancreatoscopy-guided pancreatic ductal stone therapy
YearRef.Patients, nDesignDeviceEHL/LLSuccess rateAE %Follow-up in mo
1999Howell et al[14]6R/MM-BEHL8306
2009Fishman et al[51]6R/MSpyglass®EHL500NA
20112Maydeo et al[21]4P/SSpyglass®LL10013.31
2013Alatawi et al[12]5P/SSpyglass®LL80%021
2014Attwel et al[19]46R/SOlympus M-B (31) vs Spyglass® (15)LL/EHL168 vs 73 (scope type)1018
2014Ito et al[23]8R/SSpyglass®EHL137.525NA
2015Attwell et al[9]28R/MSpyglass®LL1792913
20162Navaneethan et al[52]5R/MSpyglass®LL800NA
2017Bekkali et al[53]6R/SSpyglass®EHL83030
2017Parbhu et al[22]20R/MSpyglass®EHL/LL857.3NA
Table 2 Role of per oral pancreatoscopy in pancreatic ductal neoplasia
YearRef.NDesignKey findingsAdjunct modalities/successAE%Follow up
1997Uehara et al[42]11PMade early diagnosis of CIS missed by other modalitiesCytology in all (with secretin)NR34 mo
1998Jung et al[39]18PVisual differentiation - IPMN, Cancer, Chr pancreatitisCytology in all62 yr
1998Mukai et al[47]25R/SPapillary lesions > 3 mm, trend towards malignancyIDUS (> sensitive than POP) for detecting protrusions > 3 mm4NA
1998Tajiri et al[54]52PVisual intraductal findings to differentiate Chr pancreatitis and neoplaisa81% success3.8NA
2000Yamaguchi et al[27]41R/SVillious/vegetative lesions with red marks correlate with atypical adenoma/cancer73.2% successNA38.5 mo
2002Kodama et al[37]42PPOP correctly identified all stenosis due to Chr pancreatitis75% success1.8NA
2002Hara et al[33]60R/SPOP + IDUS 88% accuracy in differentiating benign vs malignant POP better for MD type, IDUS better for SB typeIDUS in 40 patients Cytology in 36 patients - Low Sens 13%738.4 mo
2003Yamao et al[41]115RProtrusion, friability 100% spec for malignant stenosis83% success (lower for pancreatic tumor > 2 cm)122 yr
2005Yamaguchi et al[43]103R/SCytology has better diagnostic value when collected by POP vs catheter Better for MD type vs SB typeCytology in 32 with POP, 71 via catheterNR18 mo
2005Yasuda et al[36]26RIDUS 100% Sens for lesions > 3 mm, POP Sens 67% No carcinoma in protrusions < 3 mm Biopsy Sens 50% for cancerIDUS0NA
2010Miura et al[48]21R/SProtrusions and vascular patterns seen better with NBI as compared to white lightNarrow Band imaging (NBI) Technical success 90%02 yr
2014Arnelo et al[34]44P/SSpyglass Sens 84%, spec 75% Acc for MD type 76% Acc for BD type 78%Obtained - Brushings in 88% Biopsy in 41%172.3 yr
2014Nagayoshi et al[35]17R/SSens for detecting malignancy Irrigation Cytology Sens 100% Biopsy Sens 25%Cytology35 - mild18.8 mo
2017Parbhu et al[22]16R/MAccuracy Biopsy 63.7% Biopsy + Visual 100%Technical success for biopsy 100%7.36 mo
2017El Hajj et al[38]79R/SAccuracy Visual 87% Visual + tissue 94% (combination)Technical success 97% Tissue acquisition was combination of brushings, POP assisted and POP directed biopsy1212 mo (minimum)
Table 3 Per oral pancreatoscopy visual findings for pancreatic ductal abnormalities
IPMNAdenocarcinomaChronic pancreatitis
Uehara et al[42]Papillary projections, irregular/nodular mucosa
Jung et al[39]Papillary projections; Villous protrusionsTumor vessels; ErosionsSmooth narrowing; White/gray mucosa; Blurred blood vessels
Tajiri et al[54]Papillary projections; Salmon eggsProtrusions; Tumor vessels; Friability, erosionsProtein plugs/stones; Edema, erythema, scar
Yamaguchi et al[27](1) Hyperplasia/Mild atypia; sessile or semi pedunculated with white color markings; (2) Severe atypia/adenocarcinoma semi pedunculated or villous or vegetative with red color markings
Kodama et al[37]Papillary projections; Nodular/villous; White/spotty/red marksDuct cut off; Friability/erosionsStones, proteins plugs; Scar, erythema; Blurred vessels
Hara et al[33]CIS/Invasive carcinoma; salmon eggs with vascular pattern; Villous/vegetative protrusions
Yamao et al[41]Coarse, granular papillary projections with mucusPapillary projection with tumor vessels; Protrusion/friabilityCoarse erythema
Miura et al[48](1) High risk - villous/vegetative with tumor vessel; (2) Low risk - sessile / semi pedunculated
El Hajj et al[38](1) Invasive - villous/vegetative papillary projections; (2) Noninvasive - granular projections with erythemaProtrusion with tumor vessel; Ulceration; Infiltrative strictureCoarse, blurred vessels, scarring, erythema and edema