Ampullary adenoma treated by endoscopic double-snare retracting papillectomy

Hiromitsu Soma, Naoteru Miyata, Shigenari Hozawa, Hajime Higuchi, Yoshiyuki Yamagishi, Yuji Nakamura, Keita Saeki, Kaori Kameyama, Yohei Masugi, Naohisa Yahagi, Takanori Kanai

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We report herein improved methods for the safe and successful completion of endoscopic papillectomy (EP). Between January 2008 and November 2011, 12 patients underwent double-snare retracting papillectomy for the treatment of lesions of the major duodenal papilla. The main outcomes were en bloc resection rates, pathological findings, and adverse events. All of the patients (mean age, 60.1 years; range, 38 to 80 years) were diagnosed with ampullary adenoma by endoscopic forceps biopsies prior to endoscopic snare papillectomy. En bloc resection by double-snare retracting papillectomy was successfully performed for all lesions (median size, 12.3 mm), comprising six tubular adenomas, one tubulovillous adenoma, three cases of epithelial atypia, one hamartomatous polyp, and one case of duodenitis with regenerative change. Significant hemorrhage and pancreatitis were observed in one case after EP. Adenoma recurrence occurred in three patients during follow-up (median, 28.5 months) at a mean interval of 2 months postoperatively (range, 1 to 3 months). No serious adverse events were observed. Double-snare retracting papillectomy is effective and feasible for treating lesions of the major duodenal papilla. Further treatment experience, including a single-arm phase II study, needs to be accumulated before conducting a randomized controlled study.

Original languageEnglish
Pages (from-to)689-692
Number of pages4
JournalGut and Liver
Volume9
Issue number5
DOIs
Publication statusPublished - 2015 Sep 1

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Keywords

  • Argon plasma coagulation
  • Endoscopic papillectomy
  • Endosonography
  • Intraductal ultrasonography
  • Tubular adenoma

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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