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Endoscopic papillectomy, single-centre experience.
Shamel Ismail1, Udd Marianne, Järvinen Heikki
1Department of Gastrointestinal and General Surgery, Helsinki University Central Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland.
Surgical Endoscopy
|June 15, 2014
Summary
Endoscopic papillectomy effectively treats benign papillary tumors. Pancreatic stenting reduces pancreatitis risk, while sphincterotomy without stenting poses a high risk. Surgery is recommended for papillary cancer.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopic Procedures
Background:
- Endoscopic removal of benign papillary tumors is increasingly performed.
- Evaluating the outcomes of endoscopic resection for papillary tumors is crucial.
Purpose of the Study:
- To assess the effectiveness and safety of endoscopic papillectomy for benign papillary tumors.
- To identify risk factors for malignancy and complications associated with the procedure.
Main Methods:
- Retrospective analysis of 61 papillectomies performed between 2000-2012.
- Categorization of patients into benign tumors without familial adenomatous polyposis (FAP), with FAP, and with ampullary cancer.
Main Results:
- Benign tumor recurrence rate was 25.5%.
- Jaundice and bile duct dilation were significant risk factors for malignancy (p < 0.001).
- Pancreatitis occurred in 9.8% of cases; pancreatic stenting reduced this risk (p = 0.045), while pancreatic sphincterotomy without stenting had a high risk (57%).
Conclusions:
- Endoscopic papillectomy is an effective treatment for benign papillary tumors.
- Pancreatic stenting is advised to decrease post-papillectomy pancreatitis risk.
- Surgery remains the recommended approach for papillary cancer.