Role of pancreatoscopy in management of pancreatic disease: A systematic review

Table 2 Role of per oral pancreatoscopy in pancreatic ductal neoplasia

Year	Ref.	N	Design	Key findings	Adjunct modalities/success	AE%	Follow up
1997	Uehara et al[42]	11	P	Made early diagnosis of CIS missed by other modalities	Cytology in all (with secretin)	NR	34 mo
1998	Jung et al[39]	18	P	Visual differentiation - IPMN, Cancer, Chr pancreatitis	Cytology in all	6	2 yr
1998	Mukai et al[47]	25	R/S	Papillary lesions > 3 mm, trend towards malignancy	IDUS (> sensitive than POP) for detecting protrusions > 3 mm	4	NA
1998	Tajiri et al[54]	52	P	Visual intraductal findings to differentiate Chr pancreatitis and neoplaisa	81% success	3.8	NA
2000	Yamaguchi et al[27]	41	R/S	Villious/vegetative lesions with red marks correlate with atypical adenoma/cancer	73.2% success	NA	38.5 mo
2002	Kodama et al[37]	42	P	POP correctly identified all stenosis due to Chr pancreatitis	75% success	1.8	NA
2002	Hara et al[33]	60	R/S	POP + IDUS 88% accuracy in differentiating benign vs malignant POP better for MD type, IDUS better for SB type	IDUS in 40 patients Cytology in 36 patients - Low Sens 13%	7	38.4 mo
2003	Yamao et al[41]	115	R	Protrusion, friability 100% spec for malignant stenosis	83% success (lower for pancreatic tumor > 2 cm)	12	2 yr
2005	Yamaguchi et al[43]	103	R/S	Cytology has better diagnostic value when collected by POP vs catheter Better for MD type vs SB type	Cytology in 32 with POP, 71 via catheter	NR	18 mo
2005	Yasuda et al[36]	26	R	IDUS 100% Sens for lesions > 3 mm, POP Sens 67% No carcinoma in protrusions < 3 mm Biopsy Sens 50% for cancer	IDUS	0	NA
2010	Miura et al[48]	21	R/S	Protrusions and vascular patterns seen better with NBI as compared to white light	Narrow Band imaging (NBI) Technical success 90%	0	2 yr
2014	Arnelo et al[34]	44	P/S	Spyglass Sens 84%, spec 75% Acc for MD type 76% Acc for BD type 78%	Obtained - Brushings in 88% Biopsy in 41%	17	2.3 yr
2014	Nagayoshi et al[35]	17	R/S	Sens for detecting malignancy Irrigation Cytology Sens 100% Biopsy Sens 25%	Cytology	35 - mild	18.8 mo
2017	Parbhu et al[22]	16	R/M	Accuracy Biopsy 63.7% Biopsy + Visual 100%	Technical success for biopsy 100%	7.3	6 mo
2017	El Hajj et al[38]	79	R/S	Accuracy Visual 87% Visual + tissue 94% (combination)	Technical success 97% Tissue acquisition was combination of brushings, POP assisted and POP directed biopsy	12	12 mo (minimum)

POP: Per oral pancreatoscopy; IDUS: Intraductal ultrasound; P: Prospective; R: Retrospective; S: Single-center; M: Multicenter; AE: Adverse events; CIS: Carcinoma in situ; MD: Main duct; SB: Side branch; Sens: Sensitivity; Spec: Specificity; Acc: Accuracy.