title: Endoscopic snare excision of a major duodenal papillary tumor.
abstract: OBJECTIVE
  Tumors of the duodenal papilla include hyperplasia, adenoma, carcinoma in adenoma, and carcinoma. Since the duodenal papilla has special anatomical characteristics and treatment involves major intervention, a correct preoperative diagnosis is essential for successful treatment.
  
  
  METHODS
  In patients with adenoma or early carcinoma of the papilla, endoscopic snare excision is indicated for complete removal of the tumor. Postoperative pancreatitis and cholangitis are major complications of endoscopic techniques, and we describe here in detail our procedure aiming to reduce the incidence of such complications.
  
  
  RESULTS
  Endoscopic snare excision of a tumor of the major duodenal papilla was carried out in 36 patients. Bleeding after endoscopic excision occurred in 6 cases (17%), postoperative pancreatitis in 11 cases (30%), and postoperative cholecystitis in 1 case (3%). All patients recovered from the complications within 1 week.
  
  
  CONCLUSIONS
  Our results suggest that the procedure for endoscopic snare excision used to resect major papillary tumors is safe and helps to prevent serious complications.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan. igarashi @ med.toho-u.ac.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Naoki
authors.initials: N
authors.lastname: Okano
authors.forename: Ken
authors.initials: K
authors.lastname: Ito
authors.forename: Takahiko
authors.initials: T
authors.lastname: Mimura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D015607:Stents; D016896:Treatment Outcome