Pancreatobiliary cases

This video demonstrates the usefulness of a new image-enhanced endoscopy system in a patient with suspected ampullary adenoma. On white-light imaging (WLI), a lobular mass-like lesion without ulceration or bleeding was observed. On narrow-band imaging (NBI), the lesional boundaries were clearly observed with strong contrast. Texture and color enhancement imaging (TXI) mode 1 helped to observe the surface meandering microvessels well while further emphasizing the surface cone-like lobularity. TXI mode 2 highlighted the surface irregular nodularity and pit pattern while maintaining visual naturalness. In patients with suspected ampullary mass, applying TXI mode can help to better identify the characteristics of mass-like lesion of ampulla of Vater and make treatment decision.