Abusharar M, Barritt C, Mavroeidis VK, Aroori S. Role of pancreatoscopy in the management of suspected and confirmed intraductal papillary mucinous neoplasm of the pancreas. World J Gastroenterol 2026; 32(4): 112635 [DOI: 10.3748/wjg.v32.i4.112635]
Corresponding Author of This Article
Vasileios K Mavroeidis, MD, PGDipClinEd, MSc, FRCS, FACS, FICS, FSSO, MFSTEd, MICR, Surgeon, Departments of Transplant and Gastrointestinal Surgery, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol BS10 5NB, United Kingdom. vasileios.mavroeidis@nhs.net
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Surgery
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 28, 2026 (publication date) through Jan 23, 2026
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World Journal of Gastroenterology
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1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Abusharar M, Barritt C, Mavroeidis VK, Aroori S. Role of pancreatoscopy in the management of suspected and confirmed intraductal papillary mucinous neoplasm of the pancreas. World J Gastroenterol 2026; 32(4): 112635 [DOI: 10.3748/wjg.v32.i4.112635]
World J Gastroenterol. Jan 28, 2026; 32(4): 112635 Published online Jan 28, 2026. doi: 10.3748/wjg.v32.i4.112635
Role of pancreatoscopy in the management of suspected and confirmed intraductal papillary mucinous neoplasm of the pancreas
Majd Abusharar, Christopher Barritt, Vasileios K Mavroeidis, Somaiah Aroori
Majd Abusharar, Somaiah Aroori, Department of Hepato-Pancreato-Biliary Surgery, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth PL6 8DH, United Kingdom
Christopher Barritt, Department of Upper Gastrointestinal Surgery, Royal Devon University Healthcare NHS Foundation Trust, North Devon District Hospital Raleigh Heights, Barnstaple EX31 4JB, Devon, United Kingdom
Vasileios K Mavroeidis, Departments of Transplant and Gastrointestinal Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, United Kingdom
Vasileios K Mavroeidis, Department of HPB Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom
Co-corresponding authors: Vasileios K Mavroeidis and Somaiah Aroori.
Author contributions: Abusharar M conducted the literature search, analysis and interpretation of data and drafted the original manuscript; Barritt C assisted in conducting the analysis, drafting of the original manuscript, and provided technical input; Mavroeidis VK and Aroori S contributed equally to this work and share senior authorship, conceptualised, designed, supervised the study and made critical revisions as co-corresponding authors; all authors prepared the final draft and approved the final version.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vasileios K Mavroeidis, MD, PGDipClinEd, MSc, FRCS, FACS, FICS, FSSO, MFSTEd, MICR, Surgeon, Departments of Transplant and Gastrointestinal Surgery, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol BS10 5NB, United Kingdom. vasileios.mavroeidis@nhs.net
Received: August 1, 2025 Revised: November 20, 2025 Accepted: December 25, 2025 Published online: January 28, 2026 Processing time: 174 Days and 10 Hours
Abstract
Intraductal papillary mucinous neoplasms (IPMN) are pre-malignant tumours of the pancreas with variable malignant potential. Imaging often fails to map the disease extent accurately and guidelines differ on surgical thresholds. Pancreatoscopy, providing direct visualisation of the pancreatic duct and the option of targeted biopsies, may be able to delineate disease boundaries and improve preoperative and intraoperative decision-making. This mini-review appraises the current role, evidence base, and technical application of pancreatoscopy in the management of suspected or confirmed IPMN, with particular focus on its impact on the extent of pancreatic resections. Reported data show detection of additional lesions in about 20%-40% of cases and changes to operative strategy in roughly one third of patients, with low complication rates and high concordance between visual features and histology. Limitations include restricted availability, learning requirements, heterogeneity of technique, absence of a standardised visual classification, and a paucity of prospective outcome data; current international guidelines remain cautious. Pancreatoscopy is a promising adjunct to refine patient selection and the extent of resection in IPMN, particularly for delineating ductal spread and guiding margins. Routine adoption will require robust prospective studies to define diagnostic accuracy, impact on recurrence and survival, and cost-effectiveness.
Core Tip: In this mini-review, we outline the current understanding of the role pancreatoscopy plays in assisting surgical decision-making for patients with intraductal papillary mucinous neoplasms. We explore its role in both preoperative decision-making, in determining who should be operate on, and intraoperative decision-making, in deciding what operation to perform. We outline the current methods used to directly visualise the pancreatic duct of patients with suspected or confirmed intraductal papillary mucinous neoplasms and discuss the safety and utility of these procedures.
