Pancreatic rest resection using band ligation snare polypectomy.

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Surgical Pathology

Background:

• Pancreatic rests can mimic other pathologies, necessitating accurate diagnosis.
• Histological confirmation is often desired for suspected pancreatic rests.
• Endoscopic features of pancreatic rests are characteristic but may require confirmation.

Purpose of the Study:

• To evaluate the efficacy and safety of endoscopic band ligation snare polypectomy (EBLSP) for removing suspected pancreatic rests.
• To compare the diagnostic yield of EBLSP with other endoscopic tissue sampling methods.
• To identify characteristic endoscopic features of gastric antral heterotopic pancreas.

Main Methods:

• Retrospective search of an electronic endoscopic report database.
• Inclusion of patients with incidentally found gastric antral subepithelial lesions.
• Recording of tissue sampling technique, pathology results, and complications.

Main Results:

• EBLSP successfully removed suspected pancreatic rests in 21 cases without complications.
• Histological diagnosis of heterotopic pancreas was achieved in 90% of EBLSP cases versus 36% of biopsy/snare cases (P = 0.001).
• Confirmed pancreatic rests showed a 6-10 mm antral subepithelial mass with central umbilication, 2-6 cm from the pylorus.

Conclusions:

• EBLSP offers a superior diagnostic yield for suspected gastric antral pancreatic rests compared to standard biopsy techniques.
• Typical endoscopic findings of pancreatic rests may obviate the need for routine histological diagnosis.
• EBLSP is a safe and effective method for tissue acquisition in suspected pancreatic rests.