[Treatment outcome after endoscopic papillectomy of tumors of the major duodenal papilla].
OBJECTIVE
Endoscopic papillectomy is reported to be relatively safe and reliable for complete resection of benign tumors of the major duodenal papilla. We evaluated methods and treatment outcome of the patients who have undergone endoscopic papillectomy.


METHODS
Medical records of 22 consecutive patients with tumor of the major duodenal papilla (10 women, 12 men; mean age 55.8+/-2.8 yrs) who have undergone endoscopic papillectomy were reviewed retrospectively. Endoscopic papillectomy was defined the successful when complete excision of the tumor was achieved.


RESULTS
Mean duration of follow-up was 8.4+/-2.4 months (range 1-43 months). Endoscopic papillectomy was successful in 16 patients (72.7%), but incomplete resection occurred in 6 patients. Only one patient showed recurrence. Histopathologic evaluation after endoscopic papillectomy revealed adenoma (n=11, 50%), high-grade dysplasia (n=3, 13.6%), adenocarcinoma (n=2, 9.1%), carcinoid (n=1), chronic inflammation (n=3, 13.6%), papillary adenomatous hyperplasia (n=1), and cavernous lymphangioma (n=1). The mean size of the resected lesions was 10.3+/-1.2 mm (range 2-20 mm). There was no factor which could predict the endoscopic success statistically. A pancreatic duct stent was placed in 11 patients (50.0%) and was removed after 3 to 39 days. There were 8 (36.8%) procedure-related complications: bleeding (n=4), papillary stenosis (n=1), perforation (n=1), cholangitis (n=1), and asymptomatic liver function abnormality (n=1). There was no pancreatitis or mortality. All the complications resolved with conservative management.


CONCLUSIONS
Endoscopic papillectomy in selected patients seemed to be highly successful and safe. Longer follow-up is needed to assess the long-term efficacy.
Han
Jimin
J
Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
Lee
Sung Koo
SK
Park
Do Hyun
DH
Choi
Jung Sik
JS
Lee
Sang Soo
SS
Seo
Dong Wan
DW
Kim
Myung Hwan
MH
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome