Journal article
Long-Term Outcomes of Endoscopic Papillectomy for Ampullary Adenomas
Digestive diseases and sciences, Vol.65(1), pp.260-268
2020
DOI: 10.1007/s10620-019-05812-2
PMID: 31463668
Abstract
Background and Aims
Endoscopic papillectomy is a safe and effective treatment for ampullary adenomas and has mostly replaced surgical local resection. Recent data have discussed the role of endoscopic removal of laterally spreading adenomas associated with ampullary adenomas. We evaluated our long-term results of endoscopic papillectomy for ampullary adenomas.
Methods
We retrospectively analyzed patients who underwent endoscopic papillectomy of biopsy-proven adenomas at our tertiary center between 1994 and 2017. Clinical success was defined as complete excision of an adenoma with no evidence of recurrence during follow-up, no evidence of cancer, and without the need for surgery.
Results
A total of 161 patients (73M/88F) with a mean age of 61 (range 19–93) were included. Mean adenoma size was 20 mm (range 5–70). In total, 114/161 patients continued endoscopic surveillance for a minimum of 6 months with a median follow-up of 30 months (range 6–283). Recurrent adenomas were diagnosed in 8 patients (7%) after a median of 36 months (range 12–138). Clinical success was 83%; 35 laterally spreading adenomas were treated, which were larger than adenomas confined to the papilla (mean size 38 mm
vs
15 mm,
P
< 0.05) and required more piecemeal resections (77%
vs
15%,
P
< 0.05). However, no difference was found in recurrence rates between the two groups (8%
vs
4%,
P
= 0.26); 24/161 (15%) of patients had adverse events including bleeding (6%) and pancreatitis (7%).
Conclusions
Endoscopic papillectomy is a safe and effective treatment for ampullary adenomas, including laterally spreading ones. Long-term surveillance demonstrates low recurrence rates at expert centers.
Details
- Title: Subtitle
- Long-Term Outcomes of Endoscopic Papillectomy for Ampullary Adenomas
- Creators
- Nadav Sahar - Virginia Mason Medical CenterRajesh Krishnamoorthi - Virginia Mason Medical CenterRichard A. Kozarek - Virginia Mason Medical CenterMichael Gluck - Virginia Mason Medical CenterMichael Larsen - Virginia Mason Medical CenterAndrew S. Ross - Virginia Mason Medical CenterShayan Irani - Virginia Mason Medical Center
- Resource Type
- Journal article
- Publication Details
- Digestive diseases and sciences, Vol.65(1), pp.260-268
- Publisher
- Springer US
- DOI
- 10.1007/s10620-019-05812-2
- PMID
- 31463668
- ISSN
- 0163-2116
- eISSN
- 1573-2568
- Language
- English
- Date published
- 2020
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359836502771
Metrics
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