Per oral cholangiopancreatoscopy in pancreatico biliary diseases - Expert consensus statements

Table 6 Consensus statement 4

In patients with main duct IPMN POPS may be used to assess the extent of tumor to assist surgical resection

Recommendation Grade C

Quality of evidence: 2+

Technical success: Technical success for POPS in patients with IPMN is reported between 73% and 92% when defined as ability to reach and examine the targeted lesion

Diagnostic accuracy: Diagnostic measures of POPS with or without POPS-guided biopsy for malignancy in IPMN are rarely reported in detail, and range from 50% to 68% sensitivity and from 87% to 100% specificity. Diagnostic accuracy seems better in main duct IPMN than in side branch IPMN

POPS findings in IPMN: The most commonly reported POPS findings associated with malignancy in IPMN are villous patterns and vascular images Granular mucosa and fish-like patterns without vascularity were not associated with malignancy

POPS and IDUS: Some studies document enhanced diagnostic accuracy when POPS is combined with endosonographic measures, particularly IDUS

Pre-operative and intra-operative POPS: The role of POPS to pre-operatively provide diagnostic information on malignancy and to pre-operatively and/or intra-operatively document the location and extent of dysplastic IPMN is generally reported

IPMN: Intraductal papillary mucinous neoplasms; POPS: Peroral pancreatoscopy; IDUS: Intraductal ultrasonography.