Safety and long-term efficacy of transduodenal excision for tumors of the ampulla of Vater

Posner, Steven; Colletti, Lisa M.; Knol, James A.; Mulholland, Michael W.; Eckhäuser, Frederic E.

doi:10.1067/msy.2000.108218

Cited by 95 publications

(80 citation statements)

References 24 publications

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“…However, on this respect, we know that forceps biopsies have high sensitivity (> 90%) for confirming the presence of adenoma but lower sensitivity for confirming adenocarcinoma, missing the diagnosis in up to 30% of cases (11,(22)(23)(24). Thus, as a general rule, the absence of carcinoma on endoscopic biopsy specimens in the setting of an ampullary adenoma does not exclude the presence of a focus of adenocarcinoma (24)(25)(26)(27)(28)(29). The accuracy of endoscopic biopsies can be enhanced when additional techniques are employed.…”

Section: Endoscopic Evaluationmentioning

confidence: 97%

“…EUS is a useful adjunct to ERCP to assess for infiltration of the periampullary wall layers and pancreatobiliary ducts but it does not have to be universally incorporated into the diagnostic evaluation of an ampullary adenoma (27,(32)(33)(34)(35)(36)(37)(38)(39). The precise role of EUS in the management of ampullary adenomas is unclear.…”

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 99%

“…2). EUS is reportedly helpful in identifying non-invasive lesions suitable for local resection, but no preoperative test has been proven to be accurate enough to substitute for clinical judgment and intraoperative pathological confirmation (27,42). A recent retrospective review of patients who underwent preoperative EUS to determine the accuracy of this technique concluded that EUS can accurately predict depth of mucosal invasion in the preoperative evaluation of suspected peri-ampullary and duodenal adenomas (specificity of 88% and negative predictive value of 90%) (35).…”

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 99%

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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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Section: Endoscopic Evaluationmentioning

confidence: 97%

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 99%

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 99%

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Endoscopic ampullectomy: A technical review

Espinel¹,

Pinedo²,

Ojeda³

et al. 2015

Rev Esp Enferm Dig

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“…Transduodenal local resection, a less invasive surgery, can be performed for benign ampullary tumors [6,7]. The tumor in our case, an adenoma located at the inferior duodenal angulus close to the ampulla of Vater, was treated successfully by means of minimally invasive submucosal dissection.…”

Section: Discussionmentioning

confidence: 96%

Laparoscopy Assisted Transduodenal Resection of a Periampullary Tumor at the Inferior Duodenal Angulus

Sakon¹,

Sekino²,

Seki³

et al. 2017

J Clin Case Rep

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“…However, on this respect, we know that sensitivity with forceps biopsies for demonstrating the presence of adenoma is > 90%; this is lower for adenocarcinoma, and there is up to 30% of miss diagnosis [11,[40][41][42] . Thus, a negative histological diagnosis of carcinoma on endoscopic biopsy of an ampullary adenoma does not exclude a possible focus of adenocarcinoma [42][43][44][45][46][47] . The accuracy of endoscopic biopsies can be enhanced when additional techniques are employed.…”

Section: Endoscopymentioning

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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Safety and long-term efficacy of transduodenal excision for tumors of the ampulla of Vater

Cited by 95 publications

References 24 publications

Endoscopic ampullectomy: A technical review

Endoscopic ampullectomy: A technical review

Laparoscopy Assisted Transduodenal Resection of a Periampullary Tumor at the Inferior Duodenal Angulus

Endoscopic management of adenomatous ampullary lesions

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