New experience of endoscopic papillectomy for ampullary neoplasms
Aim To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics. Patients and methods This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between...
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creator | Li, Shuling Wang, Zikai Cai, Fengchun Linghu, Enqiang Sun, Gang Wang, Xiangdong Meng, Jiangyun Du, Hong Yang, Yunsheng Li, Wen |
description | Aim
To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics.
Patients and methods
This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed.
Results
Endoscopic papillectomy was technically feasible in all patients, and was mainly performed by four experienced endoscopists. The primary success rate of endoscopic papillectomy for ampullary neoplasms was 78.2%. A total of 13 patients experienced recurrence during a mean follow-up period of 16.28 months (range 6–132 months), the predictive factors that were related to recurrence were complete resection (53.8% vs. 94.2%;
P
= 0.001), and final pathology findings (
P
= 0.001). Delayed hemorrhage, the most common procedure-related complication, occurred in 20% (22/110) of patients and was significantly related to intraoperative bleeding (
P
= 0.042). Pancreatitis was the second most common complication, which was closely related to intraoperative bleeding requiring intervention (
P
= 0.040) and larger tumor size (
P
= 0.044). Histology, type of resection, stent placement, sphincterotomy, and duration of procedure were not related to post-procedure hemorrhage or pancreatitis. Older age (63.7 ± 13.5 vs. 57.4 ± 12.2;
P
= 0.033), jaundice (47.8% vs. 13.8%;
P
= 0.001), endoscopic forceps biopsy diagnosis of high-grade intraepithelial neoplasia (82.6% vs. 14.9%;
P
= 0.001), tumor size ≥ 2 cm (60.9% vs. 34.5%;
P
= 0.022), and dilation of the bile duct (34.8% vs. 9.2%;
P
= 0.006) were clinical features for ampullary carcinoma. The rate of complete resection (52.2% vs. 92.0%;
P
= 0.001) and recurrence (34.8% vs. 6.8%;
P
= 0.001) were also related to the diagnosis of ampullary carcinoma at final pathology.
Conclusions
Endoscopic papillectomy is a feasible and reasonable option for both diagnosis and treatment of tumors of the duodenal papilla in properly selected patients. |
doi_str_mv | 10.1007/s00464-018-6577-2 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2132727230</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2132727230</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-8d36dd79bdedd62c2c7b761899a9610dc49e4012564cb0b297af76cf7dd982d73</originalsourceid><addsrcrecordid>eNp1kEtLAzEYRYMotlZ_gBsZcOMmmlfzWJbiC0Q3ug4zSUamzExi0kH7702dqiBIFlnkfPe7OQCcYnSJERJXCSHGGURYQj4XApI9MMWMEkgIlvtgihRFkAjFJuAopRXKuMLzQzChiBGMJJ2CxaN7L9xHcLFxvXGFrwvXW5-MD40pQhmatnVm7btNUftYlF0Y2raMm6J3PrRl6tIxOKjLNrmT3T0DLzfXz8s7-PB0e79cPEDDqFxDaSm3VqjKOms5McSISnAslSoVx8gaphxDmMw5MxWqiBJlLbiphbVKEivoDFyMuSH6t8Glte6aZFxuk6sMSRNMiciHooye_0FXfoh9bvdF5SVUyUzhkTLRpxRdrUNsuvw3jZHe-tWjX5396q1fTfLM2S55qDpnfya-hWaAjEDKT_2ri7-r_0_9BFHGhOw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2132125398</pqid></control><display><type>article</type><title>New experience of endoscopic papillectomy for ampullary neoplasms</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Li, Shuling ; Wang, Zikai ; Cai, Fengchun ; Linghu, Enqiang ; Sun, Gang ; Wang, Xiangdong ; Meng, Jiangyun ; Du, Hong ; Yang, Yunsheng ; Li, Wen</creator><creatorcontrib>Li, Shuling ; Wang, Zikai ; Cai, Fengchun ; Linghu, Enqiang ; Sun, Gang ; Wang, Xiangdong ; Meng, Jiangyun ; Du, Hong ; Yang, Yunsheng ; Li, Wen</creatorcontrib><description>Aim
To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics.
Patients and methods
This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed.
Results
Endoscopic papillectomy was technically feasible in all patients, and was mainly performed by four experienced endoscopists. The primary success rate of endoscopic papillectomy for ampullary neoplasms was 78.2%. A total of 13 patients experienced recurrence during a mean follow-up period of 16.28 months (range 6–132 months), the predictive factors that were related to recurrence were complete resection (53.8% vs. 94.2%;
P
= 0.001), and final pathology findings (
P
= 0.001). Delayed hemorrhage, the most common procedure-related complication, occurred in 20% (22/110) of patients and was significantly related to intraoperative bleeding (
P
= 0.042). Pancreatitis was the second most common complication, which was closely related to intraoperative bleeding requiring intervention (
P
= 0.040) and larger tumor size (
P
= 0.044). Histology, type of resection, stent placement, sphincterotomy, and duration of procedure were not related to post-procedure hemorrhage or pancreatitis. Older age (63.7 ± 13.5 vs. 57.4 ± 12.2;
P
= 0.033), jaundice (47.8% vs. 13.8%;
P
= 0.001), endoscopic forceps biopsy diagnosis of high-grade intraepithelial neoplasia (82.6% vs. 14.9%;
P
= 0.001), tumor size ≥ 2 cm (60.9% vs. 34.5%;
P
= 0.022), and dilation of the bile duct (34.8% vs. 9.2%;
P
= 0.006) were clinical features for ampullary carcinoma. The rate of complete resection (52.2% vs. 92.0%;
P
= 0.001) and recurrence (34.8% vs. 6.8%;
P
= 0.001) were also related to the diagnosis of ampullary carcinoma at final pathology.
Conclusions
Endoscopic papillectomy is a feasible and reasonable option for both diagnosis and treatment of tumors of the duodenal papilla in properly selected patients.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6577-2</identifier><identifier>PMID: 30421083</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Ampulla of Vater - pathology ; Ampulla of Vater - surgery ; Biopsy - methods ; Duodenal Neoplasms - pathology ; Duodenal Neoplasms - surgery ; Endoluminal Surgery ; Endoscopy ; Endoscopy, Digestive System - adverse effects ; Endoscopy, Digestive System - methods ; Feasibility Studies ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Pancreatitis ; Pathology ; Proctology ; Retrospective Studies ; Surgery ; Treatment Outcome ; Tumors</subject><ispartof>Surgical endoscopy, 2019-02, Vol.33 (2), p.612-619</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-8d36dd79bdedd62c2c7b761899a9610dc49e4012564cb0b297af76cf7dd982d73</citedby><cites>FETCH-LOGICAL-c438t-8d36dd79bdedd62c2c7b761899a9610dc49e4012564cb0b297af76cf7dd982d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6577-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6577-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30421083$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Shuling</creatorcontrib><creatorcontrib>Wang, Zikai</creatorcontrib><creatorcontrib>Cai, Fengchun</creatorcontrib><creatorcontrib>Linghu, Enqiang</creatorcontrib><creatorcontrib>Sun, Gang</creatorcontrib><creatorcontrib>Wang, Xiangdong</creatorcontrib><creatorcontrib>Meng, Jiangyun</creatorcontrib><creatorcontrib>Du, Hong</creatorcontrib><creatorcontrib>Yang, Yunsheng</creatorcontrib><creatorcontrib>Li, Wen</creatorcontrib><title>New experience of endoscopic papillectomy for ampullary neoplasms</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Aim
To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics.
Patients and methods
This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed.
Results
Endoscopic papillectomy was technically feasible in all patients, and was mainly performed by four experienced endoscopists. The primary success rate of endoscopic papillectomy for ampullary neoplasms was 78.2%. A total of 13 patients experienced recurrence during a mean follow-up period of 16.28 months (range 6–132 months), the predictive factors that were related to recurrence were complete resection (53.8% vs. 94.2%;
P
= 0.001), and final pathology findings (
P
= 0.001). Delayed hemorrhage, the most common procedure-related complication, occurred in 20% (22/110) of patients and was significantly related to intraoperative bleeding (
P
= 0.042). Pancreatitis was the second most common complication, which was closely related to intraoperative bleeding requiring intervention (
P
= 0.040) and larger tumor size (
P
= 0.044). Histology, type of resection, stent placement, sphincterotomy, and duration of procedure were not related to post-procedure hemorrhage or pancreatitis. Older age (63.7 ± 13.5 vs. 57.4 ± 12.2;
P
= 0.033), jaundice (47.8% vs. 13.8%;
P
= 0.001), endoscopic forceps biopsy diagnosis of high-grade intraepithelial neoplasia (82.6% vs. 14.9%;
P
= 0.001), tumor size ≥ 2 cm (60.9% vs. 34.5%;
P
= 0.022), and dilation of the bile duct (34.8% vs. 9.2%;
P
= 0.006) were clinical features for ampullary carcinoma. The rate of complete resection (52.2% vs. 92.0%;
P
= 0.001) and recurrence (34.8% vs. 6.8%;
P
= 0.001) were also related to the diagnosis of ampullary carcinoma at final pathology.
Conclusions
Endoscopic papillectomy is a feasible and reasonable option for both diagnosis and treatment of tumors of the duodenal papilla in properly selected patients.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Ampulla of Vater - pathology</subject><subject>Ampulla of Vater - surgery</subject><subject>Biopsy - methods</subject><subject>Duodenal Neoplasms - pathology</subject><subject>Duodenal Neoplasms - surgery</subject><subject>Endoluminal Surgery</subject><subject>Endoscopy</subject><subject>Endoscopy, Digestive System - adverse effects</subject><subject>Endoscopy, Digestive System - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Pancreatitis</subject><subject>Pathology</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kEtLAzEYRYMotlZ_gBsZcOMmmlfzWJbiC0Q3ug4zSUamzExi0kH7702dqiBIFlnkfPe7OQCcYnSJERJXCSHGGURYQj4XApI9MMWMEkgIlvtgihRFkAjFJuAopRXKuMLzQzChiBGMJJ2CxaN7L9xHcLFxvXGFrwvXW5-MD40pQhmatnVm7btNUftYlF0Y2raMm6J3PrRl6tIxOKjLNrmT3T0DLzfXz8s7-PB0e79cPEDDqFxDaSm3VqjKOms5McSISnAslSoVx8gaphxDmMw5MxWqiBJlLbiphbVKEivoDFyMuSH6t8Glte6aZFxuk6sMSRNMiciHooye_0FXfoh9bvdF5SVUyUzhkTLRpxRdrUNsuvw3jZHe-tWjX5396q1fTfLM2S55qDpnfya-hWaAjEDKT_2ri7-r_0_9BFHGhOw</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Li, Shuling</creator><creator>Wang, Zikai</creator><creator>Cai, Fengchun</creator><creator>Linghu, Enqiang</creator><creator>Sun, Gang</creator><creator>Wang, Xiangdong</creator><creator>Meng, Jiangyun</creator><creator>Du, Hong</creator><creator>Yang, Yunsheng</creator><creator>Li, Wen</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190201</creationdate><title>New experience of endoscopic papillectomy for ampullary neoplasms</title><author>Li, Shuling ; Wang, Zikai ; Cai, Fengchun ; Linghu, Enqiang ; Sun, Gang ; Wang, Xiangdong ; Meng, Jiangyun ; Du, Hong ; Yang, Yunsheng ; Li, Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-8d36dd79bdedd62c2c7b761899a9610dc49e4012564cb0b297af76cf7dd982d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Ampulla of Vater - pathology</topic><topic>Ampulla of Vater - surgery</topic><topic>Biopsy - methods</topic><topic>Duodenal Neoplasms - pathology</topic><topic>Duodenal Neoplasms - surgery</topic><topic>Endoluminal Surgery</topic><topic>Endoscopy</topic><topic>Endoscopy, Digestive System - adverse effects</topic><topic>Endoscopy, Digestive System - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Pancreatitis</topic><topic>Pathology</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Shuling</creatorcontrib><creatorcontrib>Wang, Zikai</creatorcontrib><creatorcontrib>Cai, Fengchun</creatorcontrib><creatorcontrib>Linghu, Enqiang</creatorcontrib><creatorcontrib>Sun, Gang</creatorcontrib><creatorcontrib>Wang, Xiangdong</creatorcontrib><creatorcontrib>Meng, Jiangyun</creatorcontrib><creatorcontrib>Du, Hong</creatorcontrib><creatorcontrib>Yang, Yunsheng</creatorcontrib><creatorcontrib>Li, Wen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Shuling</au><au>Wang, Zikai</au><au>Cai, Fengchun</au><au>Linghu, Enqiang</au><au>Sun, Gang</au><au>Wang, Xiangdong</au><au>Meng, Jiangyun</au><au>Du, Hong</au><au>Yang, Yunsheng</au><au>Li, Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>New experience of endoscopic papillectomy for ampullary neoplasms</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>33</volume><issue>2</issue><spage>612</spage><epage>619</epage><pages>612-619</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Aim
To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics.
Patients and methods
This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed.
Results
Endoscopic papillectomy was technically feasible in all patients, and was mainly performed by four experienced endoscopists. The primary success rate of endoscopic papillectomy for ampullary neoplasms was 78.2%. A total of 13 patients experienced recurrence during a mean follow-up period of 16.28 months (range 6–132 months), the predictive factors that were related to recurrence were complete resection (53.8% vs. 94.2%;
P
= 0.001), and final pathology findings (
P
= 0.001). Delayed hemorrhage, the most common procedure-related complication, occurred in 20% (22/110) of patients and was significantly related to intraoperative bleeding (
P
= 0.042). Pancreatitis was the second most common complication, which was closely related to intraoperative bleeding requiring intervention (
P
= 0.040) and larger tumor size (
P
= 0.044). Histology, type of resection, stent placement, sphincterotomy, and duration of procedure were not related to post-procedure hemorrhage or pancreatitis. Older age (63.7 ± 13.5 vs. 57.4 ± 12.2;
P
= 0.033), jaundice (47.8% vs. 13.8%;
P
= 0.001), endoscopic forceps biopsy diagnosis of high-grade intraepithelial neoplasia (82.6% vs. 14.9%;
P
= 0.001), tumor size ≥ 2 cm (60.9% vs. 34.5%;
P
= 0.022), and dilation of the bile duct (34.8% vs. 9.2%;
P
= 0.006) were clinical features for ampullary carcinoma. The rate of complete resection (52.2% vs. 92.0%;
P
= 0.001) and recurrence (34.8% vs. 6.8%;
P
= 0.001) were also related to the diagnosis of ampullary carcinoma at final pathology.
Conclusions
Endoscopic papillectomy is a feasible and reasonable option for both diagnosis and treatment of tumors of the duodenal papilla in properly selected patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30421083</pmid><doi>10.1007/s00464-018-6577-2</doi><tpages>8</tpages></addata></record> |
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subjects | Abdominal Surgery Adult Aged Ampulla of Vater - pathology Ampulla of Vater - surgery Biopsy - methods Duodenal Neoplasms - pathology Duodenal Neoplasms - surgery Endoluminal Surgery Endoscopy Endoscopy, Digestive System - adverse effects Endoscopy, Digestive System - methods Feasibility Studies Female Gastroenterology Gynecology Hepatology Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Pancreatitis Pathology Proctology Retrospective Studies Surgery Treatment Outcome Tumors |
title | New experience of endoscopic papillectomy for ampullary neoplasms |
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