Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth.

Abstract:

BACKGROUND:Endoscopic papillectomy of benign papillary tumor is still not widely practiced. Intraductal growth has been considered a contraindication for endoscopic therapy. This prospective study evaluates endoscopic papillectomy for treatment of benign papillary tumors without and with intraductal growth. METHODS:Monofilament snare and monopolar electrocoagulation were used for papillectomy. A 7F stent was placed in the pancreatic duct. Patients with distal intraductal growth underwent sphincterotomy and endoscopic resection after exclusion of more proximal growth. RESULTS:Between February 1985 and April 2004, 106 patients (109 lesions), 68 women, 38 men, median age 68 years (range 29-88 years) were included. Median tumor size was 2 cm (range 0.5-6 cm) with one session (range 1-8) required for removal. Nine patients had invasive carcinoma (8%). Surgery for incomplete removal or recurrence was performed in 12% of 75 patients without and 37% of 31 patients with intraductal growth (p < 0.01), respectively. Fifteen patients had recurrence (15%); but, only 4 required surgery. Endoscopic resection was curative (median follow-up, 43 months) in 83% without and 46% with intraductal growth (p < 0.001). CONCLUSIONS:Endoscopic papillectomy is safe and effective, and may be feasible in cases of intraductal growth. Surveillance and, if required, re-treatment are mandatory because of the risk of recurrence.

journal_name

Gastrointest Endosc

authors

Bohnacker S,Seitz U,Nguyen D,Thonke F,Seewald S,deWeerth A,Ponnudurai R,Omar S,Soehendra N

doi

10.1016/j.gie.2005.04.053

keywords:

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

551-60

issue

4

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(05)01957-7

journal_volume

62

pub_type

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