NDLI: A novel approach emphasizing preoperative margin enhancement of tumor of the major duodenal papilla with narrow-band imaging in comparison to indigo carmine chromoendoscopy (with videos).

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A novel approach emphasizing preoperative margin enhancement of tumor of the major duodenal papilla with narrow-band imaging in comparison to indigo carmine chromoendoscopy (with videos).

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Itoi, Takao Tsuji, Shujiro Sofuni, Atsushi Itokawa, Fumihide Kurihara, Toshio Tsuchiya, Takayoshi Ishii, Kentaro Ikeuchi, Nobuhito Igarashi, Masahiro Gotoda, Takuji Moriyasu, Fuminori
Description	Country affiliation: Japan Author Affiliation: Itoi T ( Department of Gastroenterology and Hepatology, Tokyo Medical University, National Cancer Institute, Shinjukuku, Tokyo, Japan. itoi@tokyo-med.ac.jp)
Abstract	BACKGROUND: Endoscopic papillectomy (EP) has been recognized as a safe and reliable treatment for tumor of the duodenal papilla. For complete resection, precise assessment of not only the intraductal extent but also the lateral margins of the tumor is mandatory before resection. OBJECTIVE: Our purpose was to prospectively assess the enhancement of the lateral margins of tumor of the duodenal papilla for the treatment of EP by comparing narrow-band imaging (NBI) and indigo carmine (IC) chromoendoscopy. DESIGN: Prospective study. SETTING: This procedure was performed in Tokyo Medical University Hospital. PATIENTS: Fourteen consecutive cases of tumors of the major duodenal papilla. INTERVENTION: All patients underwent EP after evaluation by NBI and IC. MAIN OUTCOME MEASUREMENT: Histologic evaluation of diagnosis of NBI and IC by comparison with en bloc tissue. RESULTS: In all lesions, either IC or NBI were superior to conventional white-light imaging except in 1 IC case. The ability of NBI observation to emphasize the tumor margin was statistically significantly better than IC observation (P< .05). The en bloc EP was endoscopically successful in all cases, without fatal adverse events. En bloc tissue revealed 13 adenomas and 1 adenoma with focal adenocarcinoma. There was no residual adenoma in lateral margin specimens, either endoscopically or histologically. LIMITATIONS: The lesions resected were all relatively small. This was not a blinded randomized study. CONCLUSION: This study demonstrated the feasibility and a certain degree of efficacy of NBI for enhancement of the tumor margin of duodenal papilla. Further blinded randomized studies involving large duodenal papillary tumors are required.
File Format	HTM / HTML
ISSN	00165107
Issue Number	1
Volume Number	69
e-ISSN	10976779
Journal	Gastrointestinal Endoscopy
Language	English
Publisher	Elsevier
Publisher Date	2009-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Gastroenterology Adenoma Pathology Ampulla Of Vater Diagnostic Imaging Methods Duodenal Neoplasms Duodenoscopy Image Enhancement Indigo Carmine Diagnosis Surgery Adult Aged Aged, 80 And Over Biopsy, Needle Cholangiopancreatography, Endoscopic Retrograde Endosonography Female Humans Immunohistochemistry Male Middle Aged Preoperative Care Prospective Studies Sensitivity And Specificity Video Recording Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Gastroenterology

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