Evaluating Suspected Intraductal Papillary Mucinous Neoplasms (IPMN) With SpyGlass Pancreatoscopy
Evaluating Suspected Intraductal Papillary Mucinous Neoplasms (IPMN) With SpyGlass Pancreatoscopy
Intraductal papillary mucinous neoplasms (IPMN) have a potential to develop into a malignant
 disease with varying severity. Decision making on when and how to make a therapeutic
 intervention is not simple. Endoscopic equipment that can enter the pancreatic duct itself
 can provide the much needed additional information on the cystic condition. Visual
 inspection, direct visual guided biopsies from the target and the cytology of the flushing
 fluid of the pancreatic duct may be helpful in the decision making process of when and how to
 treat the condition. We study whether SpyGlass pancreatoscopy brings accuracy to the
 diagnostic process concerning IPMNs and does it provide additional information to help make
 decisions about therapeutical interventions. We also document complications related to the
 procedure itself in the following weeks after the procedure.
In this part retrospective, part prospective single-center study we look in to the patients
 who have undergone SpyGlass pancreatoscopy in Helsinki University Hospital in the recent
 years, and recruit patients continuously to obtain a significant amount of study subjects. We
 investigate the radiological findings and diagnoses before the SpyGlass procedure, and if
 ERCP (endoscopic retrograde cholangiopancreatography) has been performed, also brush
 cytology.

 During the SpyGlass procedure we collect direct visual guided biopsies of the suspected IPMN
 area and the flushing liquid used in the pancreatic duct. We then compare the diagnosis given
 by the collected samples to the ones the patients had based on examinations before the
 SpyGlass pancreatoscopy.

 Our SpyGlass pancreatoscopy technique is different compared to previous studies. With our
 equipment we are able to provide pancreatoscopy to patients, who previously have had an
 endoscopic stenting procedure affecting their pancreatic duct. We also collect and analyze
 the flushing fluid for malignant cells, which haven't been done before. With these new means
 we hope to get more accurate results.
Inclusion Criteria:

 -  Medical imaging showing cystic pancreatic lesions.

 -  Medical imaging showing dilatation of the pancreatic duct

 Exclusion Criteria:

 - Malignancy confirmed by previous examinations