Current status of endoscopic papillectomy for ampullary tumors

Gut and Liver
Jong Ho MoonYun Nah Lee

Abstract

Detection of tumors of the ampulla of Vater, including ampullary adenoma, has been improved by routine screening endoscopic procedures and imaging modalities. Endoscopic resection by endoscopic papillectomy is rapidly replacing classic surgical resection and is a less invasive procedure. Endoscopic resection can have a role not only in the final histopathologic diagnosis but also as a definite therapeutic option. However, the indications for endoscopic resection are not fully established, and endoscopic procedures are not standardized. Significant complications, including severe pancreatitis, intractable bleeding and duodenal perforation, are rare but can occur, especially in less experienced hands. Severe pancreatitis is the most feared complication, but it can be prevented by pancreatic duct stent insertion in most cases. However, in some cases, pancreatic stenting can be challenging after resection. Incomplete resections are sometimes performed to avoid complications. Endoscopic surveillance is also important for identifying and managing remnant adenomatous tissue or recurrent lesions. Further technical development is needed to expand the indications for this procedure, minimize complications and ensure a high success rate.

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Citations

Jan 19, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Lutz SchneiderThilo Hackert
Jun 26, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shinichiro MuroHiroyuki Okada
Jun 9, 2018·United European Gastroenterology Journal·Kwang Hyun ChungYong-Tae Kim
Aug 30, 2019·Digestive Diseases and Sciences·Nadav SaharShayan Irani
Jan 27, 2016·World Journal of Gastroenterology : WJG·Jonathan P GasparAndrew Y Wang
Oct 4, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Beatrice OrlandiniGuido Costamagna
Jan 3, 2021·Updates in Surgery·Fabio Francesco di MolaPierluigi di Sebastiano
Nov 13, 2020·World Journal of Gastroenterology : WJG·Lei JiangHong-Bin Wang
May 1, 2021·Journal of Clinical Medicine·Ugo MarcheseDavid Fuks

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Methods Mentioned

BETA
surgical resection
biopsy
biopsies

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