ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand)

Video Transcription

Video Summary

In this video, Dr. Stuart Sherman and Dr. Mohamed Al-Haddad discuss a case of a 74-year-old female with a cystic lesion in the neck of the pancreas. The patient has a history of chronic gastroesophageal reflux disease and a family history of pancreatic cancer. They perform an endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to assess the cyst and determine its underlying pathology. They use a needle-based confocal laser endomicroscopy (NCLE) to visualize the cyst wall and evaluate its cellular features. The NCLE reveals finger-like projections in the cyst wall, indicating a side branch intraductal papillary mucinous neoplasm (IPMN). They discuss the importance of molecular markers and cytology in determining the nature of the cyst and the need for surgical intervention. The doctors also demonstrate the use of a Moray forceps to obtain tissue samples from the cyst wall. They emphasize that these advanced techniques should be used selectively, based on the clinical presentation and the need for further evaluation. The video concludes with a discussion of the potential risks and complications associated with these procedures.

Asset Subtitle

Mohamad Al-Haddad, MD

Keywords

cystic lesion

pancreas

endoscopic ultrasound-guided fine needle aspiration

needle-based confocal laser endomicroscopy

intraductal papillary mucinous neoplasm

molecular markers

cytology