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Can papillary carcinomas be treated by endoscopic ampullectomy?
Saïda Salmi1, Salah Ezzedine, Veronique Vitton
1Department of Gastroenterology and Hepatology, North Hospital, Marseille, France.
Surgical Endoscopy
|October 21, 2011
Summary
Endoscopic ampullectomy can successfully treat intramucosal carcinomas, offering a less invasive option. However, complication rates are higher for papillary carcinomas compared to benign tumors.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopic Procedures
Background:
- The debate continues regarding endoscopic versus surgical ampullectomy for ampullary tumors, especially malignant ones.
- This study focuses on the outcomes of endoscopic ampullectomy for carcinoma treatment.
Purpose of the Study:
- To prospectively evaluate the outcomes of endoscopic ampullectomy.
- To specifically assess its efficacy in treating ampullary carcinomas.
Main Methods:
- A prospective study involving 61 patients undergoing endoscopic ampullectomy between February 2002 and December 2008.
- Pre-procedure echoendoscopy was performed to confirm T1N0 lesions without orifice invasion.
Main Results:
- Histological analysis revealed various diagnoses, including adenocarcinoma (16%) and well-differentiated endocrine carcinoma (5%).
- Endoscopic ampullectomy achieved oncologic resection for intramucosal adenocarcinomas and endocrine carcinomas without recurrence.
- Complication rates were significantly higher for carcinomas (30.5%) than for benign tumors (14.5%).
Conclusions:
- Endoscopic ampullectomy is effective for oncologic resection of well-differentiated intramucosal carcinomas with negative margins.
- Papillary carcinomas are associated with an increased risk of complications following endoscopic ampullectomy.
