Efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms
10.3760/cma.j.cn112152-20200619-00580
- VernacularTitle:内镜下切除十二指肠乳头部肿瘤的疗效和安全性
- Author:
Jian WANG
1
;
Shun HE
;
Jiqing ZHU
;
Liyan XUE
;
Lan AN
;
Yueming ZHANG
;
Lizhou DOU
;
Yong LIU
;
Yan KE
;
Xudong LIU
;
Yumeng LIU
;
Hairui WU
;
Pingping LIU
;
Huaying XUN
;
Xue ZHANG
;
Xinzhang JIA
;
Guiqi WANG
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院内镜科 100021
- Keywords:
Neoplasms, major duodenal papilla;
Endoscopic papillectomy;
Therapeutic effect;
Safety
- From:
Chinese Journal of Oncology
2021;43(3):329-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms.Methods:The clinical-pathological data of 21 patients who were admitted to the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and underwent endoscopic papillectomy of major duodenal papilla neoplasms from January 2014 to January 2020 were retrospectively studied, their postoperative outcomes and complication were also analyzed.Results:Tweenty-one patients were successfully performed endoscopic papillectomy of major duodenal papilla neoplasms. The resected lesions varied between 0.5-2.8 cm. Completed lesion was resected in 19 cases and lesion blocks in 2 cases. The incidence of postoperative complication was 52.4% (11/21), including 8 cases of postoperative bleeding (38.1%). Five patients stopped bleeding after endoscopic hemostasis and 3 patients stopped after interventional embolization. Two patients experienced perforation (9.5%) and recovered after conservative treatment including anti-inflammatory treatment and abdominal drainage. Five patients had pancreatitis (23.8%) and recovered after treatment with pre-somatostatin and anti-inflammatory rectal suppository. Preoperative pathological results of 21 patients suggested that 11 were high-grade intraepithelial neoplasia and 8 were low-grade intraepithelial neoplasia, and 2 were chronic inflammation. Postoperative pathological results suggested that 4 were adenocarcinoma, and the rest 17 were adenoma. The coincidence rate of preoperative biopsy results and postoperative pathology was 38.1%(8/21), and underestimate of the pathological stage occurred in 11 patients (52.4%) during the preoperative biopsy, overestimate occurred in two patients (9.5%). Four cases had a positive incisal margin. All patients had good prognoses and no death event occurred during the follow-up period.Conclusions:Early-stage major duodenal papilla neoplasms should be treated with aggressive resection. Endoscopic papillectomy of duodenal papilla neoplasms is safe, effective, and can be recommended as the preferred procedure for major duodenal papilla neoplasms.
