scholarly journals Current Status of Endoscopic Papillectomy for Ampullary Tumors

Gut and Liver ◽  
2014 ◽  
Vol 8 (6) ◽  
pp. 598-604 ◽  
Author(s):  
Jong Ho Moon ◽  
Hyun Jong Choi ◽  
Yun Nah Lee
Keyword(s):  
Current Status ◽  
Endoscopic Papillectomy ◽  
Ampullary Tumors

scholarly journals Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endoscopy ◽  
2021 ◽  
Author(s):  
Geoffroy Vanbiervliet ◽  
Marin Strijker ◽  
Marianna Arvanitakis ◽  
Arthur Aelvoet ◽  
Urban Arnelo ◽  
...  
Keyword(s):  
Clinical Success ◽  
Endoscopic Management ◽  
R0 Resection ◽  
En Bloc ◽  
Strong Recommendation ◽  
Moderate Quality ◽  
Endoscopic Papillectomy ◽  
Pancreatic Duct Stenting ◽  
Ampullary Tumors ◽  
Quality Evidence

Main Recommendations 1 ESGE recommends against diagnostic/therapeutic papillectomy when adenoma is not proven.Strong recommendation, low quality evidence. 2 ESGE recommends endoscopic ultrasound and abdominal magnetic resonance cholangiopancreatography (MRCP) for staging of ampullary tumors.Strong recommendation, low quality evidence. 3 ESGE recommends endoscopic papillectomy in patients with ampullary adenoma without intraductal extension, because of good results regarding outcome (technical and clinical success, morbidity, and recurrence).Strong recommendation, moderate quality evidence. 4 ESGE recommends en bloc resection of ampullary adenomas up to 20–30 mm in diameter to achieve R0 resection, for optimizing the complete resection rate, providing optimal histopathology, and reduction of the recurrence rate after endoscopic papillectomy.Strong recommendation, low quality evidence. 5 ESGE suggests considering surgical treatment of ampullary adenomas when endoscopic resection is not feasible for technical reasons (e. g. diverticulum, size > 4 cm), and in the case of intraductal involvement (of > 20 mm). Surveillance thereafter is still mandatory.Weak recommendation, low quality evidence. 6 ESGE recommends direct snare resection without submucosal injection for endoscopic papillectomy.Strong recommendation, moderate quality evidence. 7 ESGE recommends prophylactic pancreatic duct stenting to reduce the risk of pancreatitis after endoscopic papillectomy.Strong recommendation, moderate quality evidence. 8 ESGE recommends long-term monitoring of patients after endoscopic papillectomy or surgical ampullectomy, based on duodenoscopy with biopsies of the scar and of any abnormal area, within the first 3 months, at 6 and 12 months, and thereafter yearly for at least 5 years.Strong recommendation, low quality evidence.

scholarly journals A Novel Technique of Endoscopic Papillectomy with Hybrid Endoscopic Submucosal Dissection for Ampullary Tumors: A Proof-of-Concept Study (with Video)

2020 ◽  
Vol 9 (8) ◽  
pp. 2671
Author(s):  
Naminatsu Takahara ◽  
Yosuke Tsuji ◽  
Yousuke Nakai ◽  
Yukari Suzuki ◽  
Akiyuki Inokuma ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Demographic Data ◽  
Postoperative Bleeding ◽  
Incomplete Resection ◽  
Proof Of Concept ◽  
Procedure Time ◽  
Concept Study ◽  
Submucosal Dissection ◽  
Endoscopic Papillectomy ◽  
Ampullary Tumors

Background: Endoscopic papillectomy (EP) carries a potential risk of procedure-related adverse events and incomplete resection. Since hybrid endoscopic submucosal dissection (ESD) had been established as an alternative option for relatively large and difficult gastrointestinal tumors, we evaluated a novel EP with hybrid ESD (hybrid ESD-EP) for curative safe margin in this proof-of-concept study. Methods: A total of eight cases who underwent hybrid ESD-EP between 2018 and 2020 were identified from our prospectively maintained database. Hybrid ESD-EP involved a (sub)circumferential incision with partial submucosal dissection, and subsequent snare resection of ampullary tumors, which was performed by two endoscopists with expertise in ESD or endoscopic retrograde cholangiopancreatography. Demographic data and clinicopathological outcomes were retrospectively evaluated. Results: En bloc resection was achieved by hybrid ESD-EP in all eight cases, with the median procedure time of 112 (range: 65–170) minutes. The median diameters of the resected specimens and tumors were 18 and 12 mm, respectively. All lateral margins were clear, whereas vertical margin was uncertain in three (38%), resulting in the complete resection rate of 63%. Postoperative bleeding and pancreatitis developed in each one (13%). No tumor recurrence was observed even in those cases with uncertain vertical margin, after a median follow-up of 244 (range, 97–678) days. Conclusions: Hybrid ESD-EP seems to be feasible and promising in ensuring the lateral resection margin. However, further investigations, especially to secure the vertical margin and to shorten the procedure time, should be required.

Tu1532 Comparative Study Between the Pre-Procedural Biopsy and the Final Diagnosis of Endoscopic Papillectomy: Does Pre-Biopsy Always Reflect the Ampullary Tumors?

2016 ◽  
Vol 83 (5) ◽  
pp. AB598
Author(s):  
Kenjiro Yamamoto ◽  
Takao Itoi ◽  
Atsushi Sofuni ◽  
Takayoshi Tsuchiya ◽  
Shujiro Tsuji ◽  
...  
Keyword(s):  
Comparative Study ◽  
Final Diagnosis ◽  
Endoscopic Papillectomy ◽  
Ampullary Tumors

scholarly journals Endoscopic papillectomy for tumors of the major duodenal papilla

2019 ◽  
Vol 24 (1) ◽  
pp. 36-42 ◽  
Author(s):  
I. Yu. Nedoluzhko ◽  
E. I. Khon ◽  
K. V. Shishin
Keyword(s):  
Postoperative Bleeding ◽  
Length Of Hospital Stay ◽  
En Bloc Resection ◽  
Prolonged Treatment ◽  
Morbidity Rate ◽  
Invasive Treatment ◽  
En Bloc ◽  
Endoscopic Papillectomy ◽  
Pancreatic Duct Stenting ◽  
Ampullary Tumors

Aim.To evaluate an effectiveness of endoscopic papillectomy (EA) for benign ampullary tumors.Material and methods.There were 45 patients with ampullary tumors who underwent endoscopic papillectomy in 2014–2018. Mean dimension of tumor was 2.25 ± 1.75 cm.Results.Papillectomy was successfully performed in all cases. En-bloc resection was completed in 24 cases (53%), while 21 (47%) patients had a piecemeal resection. Pancreatic duct stenting was carried out in 30 (67%) cases. Postoperative complication rate was 31%. Postoperative bleeding occurred in 8 (18%) cases, perforation in 4 (8.9%) cases, acute pancreatitis in 2 (4.4%) cases. Mortality was 4.4 % (n= 2). Local recurrence rate within 4-year period was 2.2% (n= 1). Mean length of hospital-stay was 13 days (13 ± 11) considering prolonged treatment of patients with complicated postoperative period.Conclusion.Endoscopic papillectomy is effective minimally invasive treatment of benign ampullary tumors. Regardless considerable morbidity rate, all of them may be effectively managed by medication or endoscopic procedure. EP can be considered as a first-line treatment of benign ampullary tumors.

Su1394 Predictors of Complete Endoscopic Papillectomy in Patients With Ampullary Tumors

2013 ◽  
Vol 77 (5) ◽  
pp. AB309
Author(s):  
Kensuke Kubota ◽  
Yuji Fujita ◽  
Yusuke Sekino ◽  
Seitaro Watanabe ◽  
Kunihiro Hosono ◽  
...  
Keyword(s):  
Endoscopic Papillectomy ◽  
Ampullary Tumors

Tips and tricks in endoscopic papillectomy of ampullary tumors: single-center experience with large case series (with videos)

2015 ◽  
Vol 22 (6) ◽  
pp. E22-E27 ◽  
Author(s):  
Shujiro Tsuji ◽  
Takao Itoi ◽  
Atsushi Sofuni ◽  
Shuntaro Mukai ◽  
Ryosuke Tonozuka ◽  
...  
Keyword(s):  
Case Series ◽  
Tips And Tricks ◽  
Single Center ◽  
Single Center Experience ◽  
Endoscopic Papillectomy ◽  
Large Case Series ◽  
Ampullary Tumors ◽  
Large Case

Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicenter prospective study

Endoscopy ◽  
2014 ◽  
Vol 46 (02) ◽  
pp. 127-134 ◽  
Author(s):  
Bertrand Napoleon ◽  
Rodica Gincul ◽  
Thierry Ponchon ◽  
Julien Berthiller ◽  
Jean Escourrou ◽  
...  
Keyword(s):  
Prospective Study ◽  
Long Term Results ◽  
Endoscopic Papillectomy ◽  
Multicenter Prospective Study ◽  
Ampullary Tumors

scholarly journals Investigation of the Indications for Endoscopic Papillectomy and Transduodenal Ampullectomy for Ampullary Tumors

2021 ◽  
Vol 10 (19) ◽  
pp. 4463
Author(s):  
Masanari Sekine ◽  
Fumiaki Watanabe ◽  
Takehiro Ishii ◽  
Takaya Miura ◽  
Yudai Koito ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tumor Size ◽  
Standard Treatment ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Choice Of Procedure ◽  
Endoscopic Papillectomy ◽  
Hospital Stays ◽  
Ampullary Tumors ◽  
Initial Choice

Objective: The standard treatment for ampullary tumors is pancreaticoduodenectomy. However, minimally invasive procedures such as endoscopic papillectomy (EP) and transduodenal ampullectomy (TDA) have recently gained popularity. Therefore, we aimed to evaluate the effectiveness of these minimally invasive procedures for ampullary tumors. Methods: We conducted a retrospective study of 42 patients who underwent either EP or TDA for ampullary tumors between June 2011 and November 2020. Results: We found that in patients with significantly larger tumors, TDA was often selected. Patients who underwent EP had significantly shorter hospital stays. No significant differences were observed regarding procedural accidents, tumor size, and recurrence. Conclusion: No differences were observed regarding the treatment outcomes of EP and TDA except hospital stay. EP is less invasive and can be the initial choice of procedure. TDA is performed when EP is not technically feasible. No significant relationship was noted between tumor size and recurrence, and careful observation of the patient’s postoperative course is required.

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