Expanding the indication of endoscopic papillectomy for T1a ampullary carcinoma

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Kenjiro YamamotoYuichi Nagakawa

Abstract

Endoscopic papillectomy (EP) has been attempted not only for benign lesions but also for early ampullary carcinoma (AC). However, there is still no sufficient evidence or consensus regarding the effectiveness of EP for early AC. Herein, we evaluated the expanding indication of EP for early AC. Between May 1999 and December 2016, 177 patients were diagnosed with ampullary tumor before undergoing EP, and their clinical and histopathological data were analyzed retrospectively. There were 27 Tis-T1a AC patients and four T1b AC patients who underwent EP. Mean tumor size was 14.1 mm for Tis-T1a AC and 17.0 mm for T1b AC. For the histological grade, 50% (2/4) of T1b AC were moderately differentiated, whereas 96.3% (26/27) of Tis-T1a AC were well differentiated and papillary. For lymphovascular invasion, one (25%) occurred in T1b AC but none occurred in Tis-T1a AC. There was no AC recurrence from the date of EP until a maximum of 5 years (Tis-T1a: mean period 48.5 months [5-60]; T1b: mean period 26.5 months [3-60]). Endoscopic papillectomy is useful and reliable for the curative treatment of T1a AC. Large-scale prospective studies with long-term follow up are needed.

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Citations

May 10, 2020·Expert Review of Gastroenterology & Hepatology·Kenjiro YamamotoTakao Itoi
Aug 31, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Kosuke IwanoShujiro Yazumi
Jun 22, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Eisuke IwasakiTakanori Kanai
Aug 3, 2020·Current Opinion in Gastroenterology·Jagpal S KlairRichard Kozarek
Feb 8, 2020·Therapeutic Advances in Gastrointestinal Endoscopy·Jan-Werner Poley, Sara Campos
Oct 28, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hiroki KawashimaMitsuhiro Fujishiro
Jul 16, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Yoonhyeong ByunJin-Young Jang
May 13, 2021·Journal of Surgical Oncology·Akira WatanabeKen Shirabe
May 18, 2021·Journal of Hepato-biliary-pancreatic Sciences·Kosuke TakahashiKazuhiko Nakao
Nov 27, 2021·Journal of Hepato-biliary-pancreatic Sciences·Kenjiro YamamotoYuko Kitagawa

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