Long-term outcomes of endoscopic papillectomy for duodenal papillary adenomas and risk factors for incomplete resection
10.3760/cma.j.cn321463-20250109-00447
- VernacularTitle:内镜下十二指肠乳头腺瘤切除术的长期预后及不完全切除的危险因素分析
- Author:
Kun LIU
1
;
Xintong ZHANG
;
Xiang ZHANG
;
Muhan NI
;
Peng YAN
;
Bei TANG
;
Wenting LI
;
Dan XU
;
Wen LI
;
Pin WANG
;
Dehua TANG
;
Xiaoping ZOU
;
Lei WANG
;
Shanshan SHEN
Author Information
1. 南京医科大学鼓楼临床医学院消化内科，南京 210008
- Publication Type:Journal Article
- Keywords:
Duodenal neoplasms;
Endoscopic papillectomy;
Complete resection;
Risk factors
- From:
Chinese Journal of Digestive Endoscopy
2025;42(7):545-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate long-term outcomes of endoscopic papillectomy (EP) for duodenal papillary adenomas and to identify risk factors for incomplete resection.Methods:Clinical data of 180 patients diagnosed as having duodenal papillary adenoma via postoperative pathology after EP in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2010 to December 2022 were retrospectively analyzed. Patients were divided into two groups based on their postoperative margin status: the complete resection group (negative resection margins) and the incomplete resection group (positive/uncertain resection margins). Recurrence rates were compared between the two groups, and logistic regression analysis was performed to identify risk factors for incomplete resection.Results:Among the 180 patients included in the study, 137 underwent complete resection, and 43 had incomplete resections. Recurrence rate was significantly higher in the incomplete resection group than that in the complete resection group (30.2% VS 15.3%, χ2=4.75, P=0.029). logistic regression analysis indicated that high-grade intraepithelial neoplasia was an independent risk factor for incomplete resection ( OR=2.43, 95% CI:1.12-5.26, P=0.024). Conclusion:Patients with incomplete resection after EP have a higher recurrence rate in the long-term follow-up. High-grade intraepithelial neoplasia is an independent risk factor for incomplete resection. Close surveillance and aggressive management are warranted for patients with positive or uncertain resection margins to mitigate the recurrence risk.
