An endoscopic procedure can improve the outlook for patients with a fairly common type of pancreatic lesion that is challenging to manage and that, if left untreated, can progress to cancer, according to a study in the September issue of GIE: Gastrointestinal Endoscopy, the peer-reviewed journal of the American Society for Gastrointestinal Endoscopy (ASGE).
Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are complicated to treat. They are located in the pancreas, but their position in the branch ducts makes them difficult to access. So the benefit of accessing these branches for resection of (removing by cutting) the lesion or lesions must be weighed against the risks. IPMNs in the branch ducts are thought to be less likely to progress to cancer than those in the main duct of the pancreas.
According to the study, “Management of branch-duct intraductal papillary mucinous neoplasms: a large single-center study to assess predictors of malignancy and long-term outcomes,” endoscopic ultrasound with fine needle aspiration (EUS-FNA) increasingly has been used to determine characteristics of these neoplasms. But the benefit of doing so has not been well described.
EUS is a technique using sound waves known as ultrasound during an endoscopic procedure to look at or through the wall of the gastrointestinal tract. Under continuous, real-time ultrasound guidance, a thin needle can be advanced into these structures to draw out (aspirate) fluid from the tissue. The cells obtained from the FNA can be analyzed under a microscope for abnormalities such as cancer.
In order to choose the most beneficial approach, doctors may rely not only on the size, but also on specific features, of the lesions in order to choose the best treatment approach. The study authors sought to determine the overall impact of this procedure on the identifying worrisome lesions and referring patients for surgery, compared …