Using laparoscopic ductoscopy to determine the extent of resection of intraductal papillary mucinous neoplasm involving the main pancreatic duct

Presenter: Jon Gerry MD | Providence Portland Medical Center Background: The extent of involvement the main pancreatic duct with IMPN can be variable. Lesions in neck or body pancreas present a challenge determining whether resection head pancreaticoduodenectomy tail distal pancreatectomy is most appropriate. Methods: We case an involving dilation throughout pancreas. performed laparoscopic ductoscopy flexible choledochoscope to determine anticipated line division and which type perform. Results: Based on findings ductosocopy, we subtotal splenectomy. specimen contained without high-grade dysplasia carcinoma. margin was not involved IMPN. Conclusion: Laparoscopic may have limited use, but it informative when pre-operative cross-sectional imaging intra-operative ultrasound both cannot appropriate for IPMN duct.