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Success and complications of endoscopic removal of giant duodenal and ampullary polyps: a comparative series.

Abstract：

BACKGROUND:Increasing reports suggest that endoscopic removal of benign ampullary and duodenal polyps is safe and frequently definitive; however, most reported polyps have been small in size (<3 cm). We have developed experience with endoscopic removal of increasingly large and complex polyps. PATIENTS:Fifty-one cases of endoscopic removal were attempted and grouped according to size: group A (n = 22) polyps 1 to 3 cm and group B (n = 29) polyps 3 cm or larger, including 7 cases larger than 5 cm. When the ampulla was involved, biductal sphincterotomy and prophylactic pancreatic duct stent placement was performed first, followed by saline solution-assisted piecemeal polypectomy, argon plasma coagulation, selective endoclip placement, and recovery of all polyp fragments. INTERVENTIONS:Endoscopic removal of duodenal and ampullary adenomas. RESULTS:The outcomes of small and large adenoma removal include mean number of endoscopic retrograde cholangiopancreatographies required for complete removal (2.09 vs 2.56, P = .392), number of complications (4.5% vs 13.9%, P = .375), discovery of unsuspected cancer (0% vs 10.3%, P = .242), and final definitive resolution (100% vs 86.2%, P = .124). Complete removal was achieved in 92.2% of all patients. LIMITATIONS:This was a single center retrospective study. CONCLUSIONS:Large (>/=3 cm) ampullary and duodenal polyps comprised 56.9% of our endoscopically treated cases and present special challenges to definitive endoscopic removal. Successful removal of even very large sessile lesions is possible with minimal increase in risk.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Eswaran SL,Sanders M,Bernadino KP,Ansari A,Lawrence C,Stefan A,Mattia A,Howell DA

doi

10.1016/j.gie.2006.06.018

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

925-32

issue

6

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(06)02138-9

journal_volume

64

pub_type

杂志文章

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