Single-step endoscopic ultrasound-guided multiple gateway drainage of complex walled-off necrosis with lumen apposing metal stents.

In this study we analyzed the feasibility and safety of single-step multiple transluminal gateway drainage (MTGD) for complex walled-off necrosis (WON) using lumen-apposing metal stents (LAMSs). Six patients underwent endoscopic ultrasound (EUS)-guided MTGD using two LAMSs. Technical success was 100%.

Preoperative diagnosis of a solid pseudopapillary tumour of the pancreas by Endoscopic Ultrasound Fine Needle Biopsy: A retrospective case series.

Background: A solid pseudopapillary tumour of the pancreas (SPTP) is a rare neoplasm.

Aim: We herein present five cases of SPTP diagnosed using endoscopic ultrasound (EUS) guided fine-needle biopsy (FNB) using a needle with side fenestration (ProCore-needle).

Methods: From January 2011 to June 2012 in five patients with SPTP tissue acquisition was carried out with a 19-gauge (4 patients) or a 22-gauge (one patient) needle.

Very high CEA level in a large pancreatic cyst: is it a surgical indication by itself?

Background: Pancreatic mucinous cystic lesions might develop malignancy if untreated, or could harbor malignancy at the time of the diagnosis. Many reports stated that cyst fluid carcinoembryonic antigen is an accurate diagnostic marker of pancreatic mucinous cysts.

Methods: A man with a incidental pancretic cystic lesion of 35 mm in diameter was admitted to our Department.

Endoscopic ultrasound-guided fine needle aspiration with 22- and 25-gauge needles in solid pancreatic masses: a prospective comparative study with randomisation of needle sequence.

Background: The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear.

Aims: To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass.

Methods: All patients with solid pancreatic masses evaluated from September 2007 to December 2008 were enrolled and underwent EUS-FNA with both 22- and 25-gauge needles with randomisation of needle sequence.

Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging.

Background: Magnetic resonance cholangiopancreatography (MRCP) is useful to assess exocrine pancreatic function by combining rapid imaging acquisition with the administration of secretin, a gastrointestinal hormone that stimulates the secretion of bile and pancreatic juice. However, extensive data on this method are lacking. This study aimed to determine whether MRCP with secretin administration is able to simultaneously detect alterations of both the pancreatic ducts and exocrine pancreatic function.

The imaging of pancreatic exocrine solid tumors: the role of computed tomography and positron emission tomography.

The only potentially radical treatment for pancreatic cancer is the removal of the tumor which can be performed by total or subtotal surgical resection of the pancreas; this is possible in the early stages of the disease when the tumor is confined to the pancreatic gland without metastasis to the liver, lymph nodes and/or the peritoneum, or involvement of the vascular system such as the celiac trunk and its branches and the superior mesenteric artery. In this paper, we describe the accuracy of computed tomography and positron emission tomography in the diagnosis of exocrine pancreatic cancer.