Pancreatoscopy for the next generation: development of the peroral electronic pancreatoscope system

Background: To improve visualization of the pancreatic duct with a pancreat oscope, we have developed the smallest known electronic endoscope, that is, the peroral electronic pancreatoscope. Methods: This instrument (2.1 mm, external diameter) was developed with a 5 0k-pixel interline charge coupled device. A peroral fiberoptic pancreatosco pe was used as control, connected to a video converter. The visibility of b oth systems was studied with a test chart. The model pancreatic duct, the o ral mucosa, and the pancreatic ducts of a healthy control subject and patie nts with chronic pancreatitis were examined with both systems. Results: The smallest visible interval (with a 5 mm distance between the ob ject and the distal end of the endoscope) was 0.07 mm with the peroral elec tronic pancreatoscope and 0.2 mm with the peroral fiberoptic pancreatoscope . The electronic instrument produced better images of the model pancreatic duct than the fiberoptic endoscope. A clear image of the small vessels of t he oral mucosa was obtained with the electronic but not with the fiberoptic instrument. The fine vessel network of the pancreatic duct was visualized only with the electronic instrument; pancreatic duct stones and rough-surfa ced pancreatic duct were shown more precisely with the electronic endoscope . Conclusions: The peroral electronic pancreatoscope provides images of the f ine detail of the pancreatic duct and will contribute to the diagnosis of p ancreatic diseases.