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New Method of Papillectomy May Decrease Recurrence: Anchoring Method versus Conventional Method.

Jonghyun Lee1,2, Yong Bo Park1, Sung Yong Han1,2

  • 1Division of Gastroenterology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.

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Summary
This summary is machine-generated.

A new anchoring endoscopic papillectomy (A-EP) method demonstrated superior en bloc resection and lower recurrence rates compared to conventional EP for ampullary tumors. This novel approach offers improved outcomes for patients undergoing this minimally invasive procedure.

Keywords:
adenomaampulla of Vatercholangiopancreatographyendoscopic retrograde

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Area of Science:

  • Gastroenterology and Endoscopy
  • Oncology
  • Surgical Innovation

Background:

  • Endoscopic papillectomy (EP) is the preferred treatment for ampullary tumors due to its lower morbidity compared to surgical resection.
  • A novel anchoring EP technique (A-EP) was developed to potentially improve resection outcomes.
  • This study retrospectively compares the efficacy and safety of A-EP versus conventional EP (C-EP).

Purpose of the Study:

  • To compare the outcomes of a new anchoring endoscopic papillectomy (A-EP) method with the conventional endoscopic papillectomy (C-EP) approach.
  • To evaluate differences in en bloc resection rates, complication incidence, and tumor recurrence between A-EP and C-EP.

Main Methods:

  • Retrospective review of 99 patients who underwent EP for ampullary adenomas between 2009 and 2021.
  • Inclusion criteria: pathological adenoma, <10 mm biliary invasion, <30 mm tumor diameter on EUS.
  • Exclusion criteria: antiplatelet/anticoagulant use, prior GI surgery, or prior biliary/pancreatic endoscopic therapy. Procedures performed by a single expert endoscopist.

Main Results:

  • The A-EP group (n=62) achieved significantly higher en bloc resection rates (95.2%) compared to the C-EP group (n=37) (78.4%, p=0.010).
  • The A-EP group showed a significantly lower recurrence rate (8.1%) than the C-EP group (37.8%, p=0.000).
  • While not statistically significant, A-EP trended towards fewer incidences of pancreatitis (p=0.081) and duct stricture (p=0.081).

Conclusions:

  • The novel anchoring endoscopic papillectomy (A-EP) method demonstrates superior en bloc resection rates compared to conventional EP (C-EP).
  • A-EP is associated with significantly lower tumor recurrence rates, suggesting improved long-term efficacy.
  • These findings support A-EP as a potentially more effective endoscopic treatment for selected ampullary tumors.