2001
DOI: 10.1007/s004230100235
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Rationale for endoscopic management of adenoma of the papilla of Vater: options and limitations

Abstract: The decision for endoscopic or surgical excision of adenomas is determined by general health status, histology, size, location, and depth of the lesion. In carcinoma of the papilla of Vater it is important to assess the tumoral ductal infiltration correctly to determine whether endoscopic resection is a viable option. Intraductal ultrasound is essential before initiating treatment and it therefore contributes to conservative therapy in patients with tumors of the papilla of Vater. Temporary placement of a shor… Show more

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Cited by 16 publications
(26 citation statements)
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References 60 publications
(124 reference statements)
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“…Consequently, a repeat endoscopy 7 to 10 days after the EST is recommended to obtain tissue to minimize artifact [24]. In addition to the attendant risks of EST, its disruption of tissue planes can reduce the accuracy of EUS [24]. Should biliary stenting be required, it should ideally be deferred until CT scanning, cytology brushings, transpapillary biopsies, IDUS, and EUS evaluations are completed or ruled unnecessary to minimize stent artifact that might decrease accuracy [12,14,16,25].…”
Section: Periampullary Mass Evaluationmentioning
confidence: 96%
See 2 more Smart Citations
“…Consequently, a repeat endoscopy 7 to 10 days after the EST is recommended to obtain tissue to minimize artifact [24]. In addition to the attendant risks of EST, its disruption of tissue planes can reduce the accuracy of EUS [24]. Should biliary stenting be required, it should ideally be deferred until CT scanning, cytology brushings, transpapillary biopsies, IDUS, and EUS evaluations are completed or ruled unnecessary to minimize stent artifact that might decrease accuracy [12,14,16,25].…”
Section: Periampullary Mass Evaluationmentioning
confidence: 96%
“…However, the impact on diagnostic accuracy is limited when biopsies are done too soon after EST [20]. Consequently, a repeat endoscopy 7 to 10 days after the EST is recommended to obtain tissue to minimize artifact [24]. In addition to the attendant risks of EST, its disruption of tissue planes can reduce the accuracy of EUS [24].…”
Section: Periampullary Mass Evaluationmentioning
confidence: 96%
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“…Unabhängig von den unterschiedlichen therapeutischen Ansätzen ist das Ziel einer jeden Therapie die komplette lokale Resektion des Tumors. Papillenadenome können heute adäquat lokal endoskopisch und/oder chirurgisch entfernt werden [2,5,6,[13][14][15]20] [20,24]. Das chirurgische Vorgehen ist deshalb die Therapie der Wahl bei Nachweis eines Papillenkarzinoms.…”
Section: Endoskopisch Interventionelle Therapieunclassified
“…In Anbetracht der hohen Inzidenz von Malignität für größere Läsionen wurde die PDE als Goldstandardtherapie betrachtet [22,23]. Endoskopische Interventionen wurden nur für Patienten mit einem hohen perioperativen Risiko oder für Patienten, die eine Operation ablehnten, in Betracht gezogen [24]. Die PDE ermöglicht zwar die komplette Resektion eines neoplastischen Prozesses, birgt jedoch auch das Risiko von Anastomosendehiszenzen (9% der Fälle) und Fistelbildung (14% der Fälle).…”
Section: Introductionunclassified