Endoscopic Papillectomy : A single center 4-year retrospective study

Aims Endoscopic papillectomy has been established as the treatment of choice for ampullary adenomas provided that certain criteria are met. Nevertheless, the evaluation studies are limited in international literature. The aim of the present study is to evaluate the efficacy and safety of this technique as long as the long-term outcomes.

Methods A retrospective study was conducted including patients undergone an endoscopic papillectomy in Oncological Hospital of Athens «Saint Savvas” during the period from May 2019 until May 2023. All cases were performed by a single experienced endoscopist. Parameters taking into account were demographic characteristics, rate of technical success of the procedure, adverse events and recurrence rate of adenomas. For the purpose of the present study, technical success was defined as the complete adenoma resection without any recurrence.

Results We included 18 patients with mean age of 60,9 years (SD±13,9 y, 67% females, 33% males). 14 of them underwent endoscopic papillectomy of major papilla (77,8%) whereas the rest 4 of them a minor papilla resection (22,2%). The rate of technical success was 94,5%. Complications appeared in 27,8% of the patients, as follows: pancreatitis (16,7%) was treated conservatively and bleeding (11,1%) was managed endoscopically. No case of perforation was observed. For the majority of patients (77,8%), the final histological review showed a low grade dysplasia adenoma, 2 patients (11,2%) were diagnosed with high grade dysplasia adenoma whereas only a single patient (5,5%) underwent a pancreaticoduodenectomy due to a adenocarcinoma histological result. In the mean follow-up duration (21,9 months, SD±17,8) , no recurrence occurred. [1]

Conclusions Endoscopic papillectomy should be considered as a safe and effective method of papillary adenomas resection in the hands of an experienced endoscopist. Complication rate is low and most of the adverse events can be managed conservatively.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Vanbiervliet G, Strijker M, Arvanitakis M. et al. Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. 2021; 53 (04) 429-448

Publication History

Article published online:
15 April 2024