Hiromitsu Watanabe

Pancreatoscopy for Mucus Producing Pancreatic Tumor

Abstract: The mucus producing tumor of the pancreas (MPT) is now drawing attention because of its characteristic clinical features. It is characterized by abundant secretion of mucin into the cystic cavity or the main pancreatic duct and relatively benign biological behavior. In this paper, endoscopic characteristics of MPT and the role of pancreatoscopy in the diagnosis of this entity are discussed. Eight cases of MPT with various histological backgrounds were examined with pancreatoscopy. Six cases underwent peroral pancreatoscopy and intraoperative pancreatoscopy was performed in four cases. The endoscopic findings of MPT are summarized as follows: 1) Granular change of the epithelium of the pancreatic duct. 2) Papillary tumor with dilatation of capillary vessles on its surface. 3) Irregularity or detachment of the epithelium of the pancreatic duct. The findings mentioned above in 1), 2) and 3) were obtained in three cases, two cases, and two cases, respectively. Except in one case, the border of the lesion with the neighboring normal mucosa was well identified.

Foreign Bodies in the Bile Duct After Laparoscopic Cholecystectomy

Abstract: A 57‐year‐old man who had undergone laparoscopic cholecystectomy three years previously was referred to our department for evaluation of foreign bodies in his abdomen. Endoscopic retrograde cholangiopancreatography revealed that the foreign bodies existed in the bile duct, and they were considered to be clips used during the laparoscopic cholecystectomy. Endoscopic sphincterotomy and removal of the foreign bodies with a Dormia basket were successfully performed. Migration of clips into the bile duct should be kept in mind as a possible late complication of laparoscopic cholecystectomy. Endoscopic sphincterotomy is a feasible treatment of choice.