Giant laterally spreading tumors of the papilla: endoscopic features, resection technique, and outcome (with videos)

Hopper, Andrew D; Bourke, Michael J.; Williams, Stephen J.; Swan, Michael P.

doi:10.1016/j.gie.2009.11.021

Cited by 57 publications

(49 citation statements)

References 28 publications

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“…Ten patients underwent a combined EMR and papillectomy and one patient had recurrence at 3 months. Bleeding occurred in 30% cases and cholecystitis in 10% [Hopper et al 2010]. A single-centre study in 59 patients, who underwent EMR of the nonampullary lesions, showed that successful resection was accomplished in 93% of cases on the initial attempt.…”

Section: Squamous Dysplasia and Cancermentioning

confidence: 98%

Endoscopic mucosal resection: who and how?

Mannath

Ragunath

2011

Therap Adv Gastroenterol

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Section: Squamous Dysplasia and Cancermentioning

confidence: 98%

Endoscopic mucosal resection: who and how?

Mannath

Ragunath

2011

Therap Adv Gastroenterol

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“…However, en bloc excision may not be technically feasible if the adenoma is of a large size, and/or there is a limited endoscopic accessibility. Piecemeal excision is usually reserved for these cases, frequently with adjuvant ablative therapy [69] . It has been postulated that this technique can reduce recurrence rates, bleeding and perforation.…”

Section: General Principlesmentioning

confidence: 99%

Endoscopic management of adenomatous ampullary lesions

Espinel¹

2015

WJM

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Lesions of the ampulla of Vater represent an uncommon group of gastrointestinal malignancies. The majority of lesions of the ampulla of Vater are either adenomas or adenocarcinomas. Ampullary lesions are often incidental findings. Accurate preoperative diagnosis and staging of ampullary tumors is imperative for predicting prognosis and determining the most appropriate therapeutic approach. Endoscopic ampullectomy is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention. This review will provide the framework for the diagnosis and management of ampullary lesions from the perspective of the practicing gastroenterologist. Strategies for safe and successful endoscopic ampullectomy with a focus on accurate preoperative diagnosis and staging, resection technique, and management of complications are presented. Core tip: Adenomatous ampullary lesions are rare. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound (EUS) have changed the management of patients with these lesions. Endoscopic ampullectomy is a technique that has revolutionized the treatment of these lesions avoiding potential complications of surgery. We herein discuss the epidemiology, the role of EUS in the local staging and the role of endoscopy in the treatment of the adenomatous ampullary neoplasms.Espinel J, Pinedo E, Ojeda V, Guerra del Rio M. Endoscopic management of adenomatous ampullary lesions. World J REVIEW

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“…However, en bloc excision may not be technically feasible if the adenoma is of a large size and/or there is a limited endoscopic accessibility. Piecemeal excision is usually reserved for these cases, frequently with adjuvant ablative therapy (46). It has been postulated that this technique can reduce recurrence rates, bleeding and perforation.…”

Section: A B C Dmentioning

confidence: 99%

Endoscopic ampullectomy: A technical review

Espinel¹,

Pinedo²,

Ojeda³

et al. 2015

Rev Esp Enferm Dig

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Background and aim:This article provides a practical review to undertaking safe endoscopic ampullectomy and highlights some of the common difficulties with this technique as well as offering strategies to deal with these challenges.Methods: We conducted a review of studies regarding endoscopic ampullectomy for ampullary neoplasms with special focus on techniques.Results: Accurate preoperative diagnosis and staging of ampullary tumors is imperative for predicting prognosis and determining the most appropriate therapeutic approach. The optimal technique for endoscopic ampullectomy is dependent on the lesions size. En bloc resection is recommended for lesions confined to the papilla. There is no significant evidence to support the submucosal injection before ampullectomy. There is no consensus regarding the optimal current and power output for endoscopic ampulectomy. The benefits of a thermal adjunctive therapy remain controversial. A prophylactic pancreatic stent reduces the incidence and severity of pancreatitis post-ampullectomy.Conclusions: Endoscopic ampullectomy is a safe and efficacious therapeutic procedure for papillary adenomas in experienced endoscopist and it can avoid the need for surgical intervention.

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Giant laterally spreading tumors of the papilla: endoscopic features, resection technique, and outcome (with videos)

Cited by 57 publications

References 28 publications

Endoscopic mucosal resection: who and how?

Endoscopic mucosal resection: who and how?

Endoscopic management of adenomatous ampullary lesions

Endoscopic ampullectomy: A technical review

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