Related Experiment Videos
Sphincter-sparing preclosure technique-assisted endoscopic papillectomy versus conventional endoscopic papillectomy
Fu-Qiang Liu1, Li-Na Ren2, Xiang-Rong Zhou3
1Department of Gastroenterology, Jianyang People's Hospital, Jianyang, China; Department of Gastroenterology and Hepatology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Background And Aims:
This multicenter retrospective cohort study aims to evaluate the efficacy and safety of sphincter-sparing preclosure technique-assisted endoscopic papillectomy (EP) versus conventional EP for duodenal papilla adenomas.
Methods:
This study enrolled 68 patients who underwent EP for duodenal papilla adenomas between July 2018 and December 2024 at the endoscopy centers of Sichuan Provincial People's Hospital and Southwest Hospital of Army Medical University. Among them, 29 patients received immediate sphincter-sparing preclosure after EP. Outcomes were compared with 39 patients without preclosure, and perioperative adverse event rates were assessed comparatively.
Results:
The preclosure procedure was successful in all patients. The delayed bleeding rate was 0% in the preclosure group versus 17.95% in the conventional group (P = .017). Notably, 85.7% of delayed bleeding events in the conventional group originated from the extrasphincteric region. The immediate bleeding rate was also significantly lower in the preclosure group (37.93% vs 66.67%; P = .027). Furthermore, the preclosure group demonstrated significantly shorter times for cannulation (6 minutes [IQR, 5-8.5] vs 8 minutes [IQR, 5-13]; P = .026) and post-EP hospitalization (6 days [IQR, 5-8] vs 7 days [IQR, 6-13]; P = .048). However, the median procedure time and stent placement time did not differ significantly between groups. Rates of post-EP pancreatitis, cholangitis, and perforation were comparable between the groups.
Conclusions:
The sphincter-sparing preclosure technique-assisted EP is a safe and effective method for duodenal papilla adenomas, which significantly reduces the incidence of delayed bleeding and shortens post-EP hospital stay.
