Role of pancreatoscopy in the management of suspected and confirmed intraductal papillary mucinous neoplasm of the pancreas

Figure 1 Workflow for resection of main-duct or mixed-type intraductal papillary mucinous neoplasm. IPMN: Intraductal papillary mucinous neoplasms.

Figure 2 Intraoperative pancreatoscopy. A: Isolation of the main pancreatic duct; B: Scope insertion into the main pancreatic duct; C: Scope lying within the main pancreatic duct handled by the surgeon; D: On-screen pancreatoscopic view with choledochoscope stack. 1: Sling isolating the neck of the pancreas and main pancreatic duct; 2: Body and tail of the pancreas; 3: Head of the pancreas; 4: Superior mesenteric vein; 5: Liver; 6: Retractor; 7: Choledochoscope; 8: Choledochoscope inserted into main pancreatic duct; 9: Inside view of main pancreatic duct; 10: Pancreatic duct lumen; 11: Choledochoscope used for pancreatoscopy; 12: Operating surgeon handling scope.