Endoscopic approach to the pancreatobiliary tract using narrow band imaging

Narrow band imaging (NBI), based on modifying spectral features by narrowing the bandwidth of spectral transmittance, makes it possible to clearly observe the microvascular architecture or fine superficial structure of the gastrointestinal tract. Using a thinner video endoscope recently developed and not equipped with magnifying mode, the authors have evaluated the clinical usage of NBI for the pancreatobiliary region. Between June and July 2006, peroral pancreatoscopy or cholangioscopy was performed for 10 patients with pancreatobiliary diseases. The scope with an outer diameter of 2.9 mm was used. Non-magnifying NBI observation was compared with standard observation. NBI observation visualized the small vessels and superficial architecture, which were difficult to depict on standard observation. Furthermore, NBI clearly delineated the margin of the small-protruding lesion. Consequently, NBI pancreatoscopy was more useful for diagnosing tumor spread in the main pancreatic duct of the intraductal mucinous neoplasm.