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Per Oral Pancreatoscopy Identification of Main-duct Intraductal Papillary Mucinous Neoplasms and Concomitant Pancreatic Duct Stones

Not Mutually Exclusive

Han, Samuel MD*; Raijman, Isaac MD; Machicado, Jorge D. MD*; Edmundowicz, Steven A. MD*; Shah, Raj J. MD*

doi: 10.1097/MPA.0000000000001333
Original Articles
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Objectives Per oral pancreatoscopy (POP) assists in the evaluation and treatment of select benign and neoplastic pancreatic disorders including main-duct intraductal papillary mucinous neoplasm (MD-IPMN). Although pancreatic duct stones are classically thought of as pathognomonic for chronic pancreatitis, its co-occurrence with MD-IPMN as identified via POP may help identify an alternative etiology for presumed idiopathic chronic pancreatitis.

Methods This was a multicenter retrospective case series of patients found to have pancreatic duct stones with concomitant MD-IPMN by POP.

Results Thirteen patients with presumed idiopathic chronic calcific pancreatitis were found on POP to have both pancreatic duct stones and MD-IPMN. All patients had a dilated pancreatic duct, and most (92.3%) were symptomatic.

Conclusions Per-oral pancreatoscopy may identify MD-IPMN as an etiology for patients with presumed idiopathic chronic calcific pancreatitis and associated dilated pancreatic duct. Larger prospective studies are needed to validate these findings.

From the *Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, CO; and

Division of Gastroenterology, Baylor St. Luke's Medical Center, Houston, TX.

Received for publication December 15, 2018; accepted April 25, 2019.

Address correspondence to: Raj J. Shah, MD, Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, 1635 Aurora Ct, Mail Stop F735, Rm. AIP 2.031, Aurora, CO 80045 (e-mail: Raj.Shah@ucdenver.edu).

Financial Support: T32T32DK007038 (S.H.).

Raj Shah is a consultant and advisory board member for Boston Scientific and consultant for Cook Medical and Olympus. Isaac Raijman is a consultant and advisory board member for Boston Scientific. Steven Edmundowicz is an advisory board member for Boston Scientific and a recipient of site-funded research from Medtronic. The rest of the authors declare no conflict of interest.

Online date: June 7, 2019

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