Papillectomy: Clinical Results
- 44 Downloads
Endoscopic papillectomy (EP) is a safe and effective first-line treatment for small tumors of the ampulla of Vater. EP may be considered as a curative treatment in case of ampullary adenoma with high-grade intraepithelial dysplasia or well-differentiated in situ tumor with negative resection margins. Predictors of long-term success (>85% of cases) include patient age >48 years, lesion size ≤24 mm, male sex, absence of polyposis syndrome, and intestinal histological subtype. Adverse events range from 10 to 35% and are successfully managed in most of the cases, sometimes after multidisciplinary evaluation. The incidence of residual/recurrent adenoma is high (about 40%), but it is balanced by the successful endoscopic re-treatment. Endoscopic surveillance is mandatory for identifying and managing residual/recurrent adenomatous tissue particularly if the surveillance intervals are not standardized.
KeywordsEndoscopic papillectomy Ampullectomy Ampullary neoplasms Ampullary adenoma Endoscopic retrograde cholangiopancreatography
- 13.Valerij G, Tringali A, Bove V, Landi R, Barbaro F, Boskoski I, Familiari P, Perri V, Costamagna G. Endoscopic papillectomy: long-term results in 110 consecutive patients. Endoscopy. 2018;50(4):S68–9.Google Scholar
- 23.Camus M, Napoléon B, Vienne A, Marc LR, Leblanc S, Barret M, Chaussade S, Robin F, Kaddour N, Prat F. Efficacy and safety of endobiliary radiofrequency ablation for the eradication of residual neoplasia after endoscopic papillectomy: a multicenter prospective study. Gastrointest Endosc. 2018;88:511–8.CrossRefGoogle Scholar