Endoscopic papillectomy: data of a prospective observational study.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Tumor-like lesions of the papilla require effective diagnostic and therapeutic strategies.
• Endoscopic papillectomy is an alternative to surgical resection for certain papillary conditions.

Purpose of the Study:

• To evaluate the clinical value, feasibility, and safety of endoscopic papillectomy for diverse papillary diseases.
• To assess treatment outcomes including R0 resection, complications, and recurrence rates.

Main Methods:

• A systematic, bicenter prospective observational study enrolled 54 patients undergoing endoscopic papillectomy.
• Patients were categorized into four groups based on endoscopic, EUS, and histopathological findings: adenoma, carcinoma/NET/lymphoma, adenomyomatosis, and cases with catheterization difficulty.
• Outcomes were measured by R0 resection, complication rates, recurrence, and tumor-free survival.

Main Results:

• Endoscopic papillectomy was performed on 58 patients over 7 years, with 54 enrolled.
• For adenomas (44.4%), R0 resection was achieved in 91.6% with an 86.4% tumor-free survival.
• For carcinoma/NET/lymphoma (33.3%), R0 resection was 75.0% with 88.9% tumor-free survival. Overall complication rate was 18.5% with 0% mortality.

Conclusions:

• Endoscopic papillectomy is a feasible and safe therapeutic option for adenomas and selected high-risk carcinomas.
• The procedure demonstrates an adequate risk-benefit ratio when performed by experienced endoscopists.
• Endoscopic ultrasonography (EUS) is valuable for preoperative diagnosis, aiding in treatment planning.