No abstract available.

No abstract available.
Animals ; Basement Membrane* ; Rats*

No abstract availble
Calculi/*therapy ; Humans ; *Lithotripsy ; Pancreatic Diseases/*therapy ; *Pancreatic Ducts

Cystic diseases of pancreas are increasingly detected because of high quality of imaging modality. Most of pancreatic cysts are discovered incidentally. Differential diagnosis of pancreatic cysts is very important because they include wide range of pathologic disease such as inflammation, benign neoplasm, borderline and malignant neoplasm. The most common cystic disease of pancreas is post-inflammatory pseudocyst, but in recent decades the incidence of neoplastic cysts, such as serous cyst neoplasm, mucinous cyst neoplasm, intraductal papillary mucinous neoplasm has increased. Among the cystic neoplasms, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm are premalignant, and serous cystadenoma has no malignant potential. Patient's age, symptoms and a possible history of acute or chronic pancreatitis together with cross-sectional imaging modalities are mainstay for differential diagnosis of cystic diseases of pancreas. Cystic fluid cytology and analysis for CEA, mucin stain, and viscosity are providing additional information for differentiation. But cross-sectional images have overlapping findings in various cystic diseases and cystic fluid aspiration has still lack of sensitivity. The purpose of this review article is to provide the overview of the differentiation of pancreatic cystic lesions.
Cystadenoma, Serous ; Diagnosis, Differential ; Incidence ; Inflammation ; Mucins ; Pancreas ; Pancreatic Cyst ; Pancreatitis, Chronic ; Viscosity

Biliary cystic tumors, such as cystadenoma and cystadenocarcinoma, are rare cystic tumors of liver accounting for fewer than 5% of all intrahepatic cysts of biliary origin. Most biliary cystic tumors arise from intrahepatic bile duct and 10-20% arise from extrahepatic bile duct like common hepatic duct, common bile duct, and gallbladder. The first case report of biliary cystic neoplasm in Korea dated back to 1975 by Bae et al, and over 40 cases of cystadenoma and 35 cases of cystadenocarcinoma were reported since then. These tumors usually present in middle-aged women with a mean age of 50 years. Biliary cystadenomas are lined by single layer of cuboidal or columnar epithelium and are very often multilocular with septal or papillary foldings. Over 80% of cystadenoma have dense mesenchymal stroma composed of dense spindle cells, like ovary. The epithelial lining of cystadenocarcinoma exhibits cellular atypia, mitotic activity, and infiltrative growth, but part of lining epithelium retain the feature of cystadenoma, which support the adenoma-carcinoma sequence. The size of tumors varies from 1.5 to 35 cm. Many patients are asymptomatic, except for the presence of palpable mass. When symptoms are present, they include epigastric or right upper quadrant pain or jaundice by enlarged mass. Biliary cystic tumor should be considered when a single or multilocular cystic lesion with papillary infoldings is detected in the liver by computed tomogram (CT) or ultrasound (US). Cystic wall and internal foldings can be seen enhanced by enhanced CT. US reveals a hypoechoic cystic mass with echogenic septation or papillary infoldings. Cystadenocarcinoma should be suspected when there is elevated mass or nodule in the wall or foldings, or thickened cystic wall on CT or US. But it is extremely difficult to differentiate between cystadenoma and cystadenocarcinoma by imaging alone. Increased tumor markers, carcinoembryonic antigen and carbohydrate antigen 19-9, in serum or cystic fluid have been reported in biliary cystic tumor. But tumor markers cannot distinguish cystadenocarcinoma from cystadenoma or both from other cystic lesions of liver. Malignant cells are not usually recovered in patients with cystadenocarcinoma who underwent cystic fluid cytology before and during surgery. The treatment of choice is radical excision of the mass by means of lobectomy or wide tumor excision. Aspiration, marsupialization, and drainage must be avoided. Inadequate excision of both cystadenoma and cystadenocarcinoma may lead to recurrence. Prognosis after complete excision is excellent.
Adult ; Aged ; *Biliary Tract Neoplasms/diagnosis/pathology/surgery ; *Cystadenocarcinoma/diagnosis/pathology/surgery ; *Cystadenoma/diagnosis/pathology/surgery ; Female ; Humans ; Male ; Middle Aged

No abstract available.
Adenocarcinoma, Mucinous/*diagnosis ; Carcinoma, Pancreatic Ductal/*diagnosis ; Carcinoma, Papillary/*diagnosis ; Humans ; Neoplasms, Multiple Primary/diagnosis/*epidemiology ; Neoplasms, Second Primary/diagnosis/epidemiology ; Pancreatic Neoplasms/*diagnosis

International Digestive Endoscopy Network (IDEN) is an international meeting covering scientific subjects of diverse topics about upper gastrointestinal (GI) endoscopy, colonoscopy, endoscopic ultrasonography, and PB endoscopy. IDEN is organized by Korean Society of Gastrointestinal Endoscopy and the Korean Gastrointestinal Endoscopy Research Foundation, and took its first step in 2011 in Seoul, Korea. IDEN inaugurated a new era of diagnostic and therapeutic GI endoscopy. IDEN 2012 was designed to offer participants from all over the world with opportunities to share up-to-date knowledge about basic and clinical aspects of GI endoscopy and to engage in in-depth discussion with worldwide well-known experts. During the 2 days of meeting, there were 62 invited lectures, 28 case-based discussions, 20 video lectures, and 6 breakfast with the experts. There were a total of 598 participants registered from 12 countries, including Asian countries, Europe, and USA as well as Korea.
Asian Continental Ancestry Group ; Breakfast ; Colonoscopy ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Europe ; Humans ; Korea ; Lectures ; Resin Cements

No abstract available.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Humans ; Manometry ; Pancreatic Ducts/*physiopathology/radiography/surgery ; Sphincter of Oddi Dysfunction/*diagnosis/physiopathology/radiography ; Tomography, X-Ray Computed

Since it was first described nearly three decades ago, endoscopic papillectomy (EP) has been utilized as a less invasive, alternative therapy for adenoma of the major duodenal papilla. In this article, we review the recent advances in EP, especially those pertaining to endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS), and pancreatic stent placement for the prevention of postpapillectomy pancreatitis. Because EUS and IDUS have similar diagnostic accuracies, either modality can be used for the preprocedural evaluation of ampullary tumors. Nevertheless, further technical refinements are required for a more precise evaluation. Given the paucity of data on the usefulness of EUS and/or IDUS during follow-up after EP, a well-designed study is warranted. Furthermore, pancreatic stent placement appears to have a protective effect against postpapillectomy pancreatitis; however, a prospective, randomized, controlled study with a larger number of patients is needed to assess this finding. Moreover, since pancreatic stent placement after EP is not always successful, various novel techniques have been developed to ensure reliable stent placement. Despite the recent advances in EP, further technical refinements and studies are needed to confirm their efficacy.
Adenoma ; Ampulla of Vater* ; Endosonography* ; Follow-Up Studies ; Humans ; Pancreatitis ; Stents* ; Ultrasonography*

No abstract available.
Endoscopy* ; Pancreatic Diseases*