Endoscopic Papillectomy for Benign Ampullary Neoplasms: How Can Treatment Outcome Be Predicted?.
- Author:
Dong Won AHN
1
;
Ji Kon RYU
;
Jaihwan KIM
;
Won Jae YOON
;
Sang Hyub LEE
;
Yong Tae KIM
;
Yong Bum YOON
Author Information
1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. jkryu@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Endoscopic sphincterotomy;
Benign papillary tumor;
Adenocarcinoma;
Endoscopic success
- MeSH:
Adenocarcinoma;
Adenoma;
Alkaline Phosphatase;
Follow-Up Studies;
Humans;
Medical Records;
Recurrence;
Retrospective Studies;
Sphincterotomy, Endoscopic;
Treatment Outcome
- From:Gut and Liver
2013;7(2):239-245
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Endoscopic papillectomy is increasingly performed with curative intent for benign papillary tumors. This study was performed to identify factors that predict the presence of malignancy and affect endoscopic success. METHODS: We retrospectively analyzed the medical records of patients who received an endoscopic papillectomy for papillary adenoma from 2006 to 2009. RESULTS: A total of 43 patients received endoscopic papillectomy. The pathologic results after papillectomy revealed adenocarcinoma in five patients (12%), and the risk of malignancy was high in cases of large lesions, preprocedural pathology of high-grade dysplasia or high serum alkaline phosphatase. Endoscopic success was observed in 37 patients (86%) at the end of follow-up (mean duration, 10.4+/-9.6 months). The factor significantly affecting success was a complete resection at the initial papillectomy (p=0.007). Two patients experienced recurrence 10 and 32 months after the complete resection, but both achieved endoscopic success with repeated endoscopic treatment. Six patients with endoscopic failure received surgical resection. CONCLUSIONS: Endoscopic papillectomy is a safe and effective method for the curative resection of benign papillary tumors, especially when complete resection is achieved at the initial papillectomy. Follow-up with surveillance should be performed for at least 3 years because of the possible recurrence of tumors during these periods.
