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The timing of recurrence after endoscopic papillectomy
Samuel Han1, Joshua A Turkeltaub2, Daniel Jonas3
1Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Surgical Endoscopy
|November 28, 2023
Summary
Endoscopic papillectomy (EP) for ampullary adenomas has a recurrence rate of 16.1%, with many cases appearing after two years. Long-term surveillance is recommended following EP procedures.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Endoscopic papillectomy (EP) is a recognized treatment for ampullary adenomas.
- Limited data exist on long-term adenoma recurrence rates after EP.
- Understanding recurrence timing is crucial for effective patient management.
Purpose of the Study:
- To investigate the timing and rate of adenoma recurrence after endoscopic papillectomy.
- To evaluate long-term outcomes following EP for ampullary adenomas.
Main Methods:
- Retrospective analysis of patients undergoing EP for ampullary adenomas (8/2000-1/2018).
- Inclusion criteria: confirmed complete adenoma eradication.
- Recurrence defined as adenomatous histology post-negative surveillance endoscopy; Kaplan-Meier estimates used.
Main Results:
- 136 patients with adenomas had complete eradication (91.2%) after EP.
- Recurrence observed in 16.1% of patients at a mean of 3.2 years post-procedure.
- 45% of recurrences occurred after the initial two years of surveillance.
Conclusions:
- Adenoma recurrence is a significant concern after EP.
- The timing of recurrence suggests the need for extended surveillance periods.
- Further multicenter studies are required to establish optimal surveillance intervals.
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