ENDOSCOPIC DIAGNOSIS AND TREATMENT OF AMPULLARY NEOPLASM (WITH VIDEO)
Background and aim: For ampullary cancer, pancreaticoduodenectomy is considered to be the standard treatment. Endoscopic papillectomy (EP) has been utilized in cases of ampullary adenoma since the early 1980s. We aimed to provide a review concerning EP. Methods: We conducted a review of studies re...
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| Veröffentlicht in: | Digestive endoscopy 2011-04, Vol.23 (2), p.113-117 |
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| creator | Ito, Kei Fujita, Naotaka Noda, Yutaka |
| description | Background and aim: For ampullary cancer, pancreaticoduodenectomy is considered to be the standard treatment. Endoscopic papillectomy (EP) has been utilized in cases of ampullary adenoma since the early 1980s. We aimed to provide a review concerning EP.
Methods: We conducted a review of studies regarding EP for ampullary neoplasms.
Results: Since neither lymphatic permeation, vascular invasion, nor lymph node metastasis is observed in patients with ampullary cancer limited to the mucosa, EP of such tumors without ductal infiltration into the pancreatic/bile duct can be justified as radical treatment. For its application in patients with ampullary neoplasms, accurate pretreatment staging is indispensable. EUS, which can be carried out on an outpatient basis with a low risk of complications, is useful for differential diagnosis as well as detection of periampullary tumors. Although intraductal US of the bile duct tends to result in overestimation of tumor staging in cases of ampullary neoplasm, it can provide useful information for making therapeutic decisions, especially in cases appropriate for EP. While the technical success rate of EP is high, the complication rate and recurrence rate are not as low as a satisfactory level. Pancreatic duct stenting after EP is expected to contribute to prevention of post‐EP pancreatitis. There is no consensus regarding the mode of resection current nor the need for addition of biliary/pancreatic sphincterotomy and biliary stenting.
Conclusions: EP has been reported to be useful in selected patients with ampullary neoplasms. Data on further long‐term follow up after EP are awaited. |
| doi_str_mv | 10.1111/j.1443-1661.2010.01101.x |
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Methods: We conducted a review of studies regarding EP for ampullary neoplasms.
Results: Since neither lymphatic permeation, vascular invasion, nor lymph node metastasis is observed in patients with ampullary cancer limited to the mucosa, EP of such tumors without ductal infiltration into the pancreatic/bile duct can be justified as radical treatment. For its application in patients with ampullary neoplasms, accurate pretreatment staging is indispensable. EUS, which can be carried out on an outpatient basis with a low risk of complications, is useful for differential diagnosis as well as detection of periampullary tumors. Although intraductal US of the bile duct tends to result in overestimation of tumor staging in cases of ampullary neoplasm, it can provide useful information for making therapeutic decisions, especially in cases appropriate for EP. While the technical success rate of EP is high, the complication rate and recurrence rate are not as low as a satisfactory level. Pancreatic duct stenting after EP is expected to contribute to prevention of post‐EP pancreatitis. There is no consensus regarding the mode of resection current nor the need for addition of biliary/pancreatic sphincterotomy and biliary stenting.
Conclusions: EP has been reported to be useful in selected patients with ampullary neoplasms. Data on further long‐term follow up after EP are awaited.</description><identifier>ISSN: 0915-5635</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/j.1443-1661.2010.01101.x</identifier><identifier>PMID: 21429014</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adenoma - diagnosis ; Adenoma - pathology ; Adenoma - surgery ; Ampulla of Vater - pathology ; Ampulla of Vater - surgery ; ampullary cancer ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct Neoplasms - diagnosis ; Common Bile Duct Neoplasms - pathology ; Common Bile Duct Neoplasms - surgery ; endoscopic papillectomy ; endoscopic ultrasonography ; Endosonography ; Humans ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; pancreatic duct stenting ; Pancreatic Ducts ; Pancreatitis - prevention & control ; papilla of the Vater ; Postoperative Complications - prevention & control ; Prognosis ; Sensitivity and Specificity ; Sphincterotomy, Endoscopic ; Stents</subject><ispartof>Digestive endoscopy, 2011-04, Vol.23 (2), p.113-117</ispartof><rights>2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society</rights><rights>2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4761-aabacb619678bc2ac72b417dc2b9d9e066bdba3eb8735556120f0223865f99fb3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1443-1661.2010.01101.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1443-1661.2010.01101.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21429014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ito, Kei</creatorcontrib><creatorcontrib>Fujita, Naotaka</creatorcontrib><creatorcontrib>Noda, Yutaka</creatorcontrib><title>ENDOSCOPIC DIAGNOSIS AND TREATMENT OF AMPULLARY NEOPLASM (WITH VIDEO)</title><title>Digestive endoscopy</title><addtitle>Dig Endosc</addtitle><description>Background and aim: For ampullary cancer, pancreaticoduodenectomy is considered to be the standard treatment. Endoscopic papillectomy (EP) has been utilized in cases of ampullary adenoma since the early 1980s. We aimed to provide a review concerning EP.
Methods: We conducted a review of studies regarding EP for ampullary neoplasms.
Results: Since neither lymphatic permeation, vascular invasion, nor lymph node metastasis is observed in patients with ampullary cancer limited to the mucosa, EP of such tumors without ductal infiltration into the pancreatic/bile duct can be justified as radical treatment. For its application in patients with ampullary neoplasms, accurate pretreatment staging is indispensable. EUS, which can be carried out on an outpatient basis with a low risk of complications, is useful for differential diagnosis as well as detection of periampullary tumors. Although intraductal US of the bile duct tends to result in overestimation of tumor staging in cases of ampullary neoplasm, it can provide useful information for making therapeutic decisions, especially in cases appropriate for EP. While the technical success rate of EP is high, the complication rate and recurrence rate are not as low as a satisfactory level. Pancreatic duct stenting after EP is expected to contribute to prevention of post‐EP pancreatitis. There is no consensus regarding the mode of resection current nor the need for addition of biliary/pancreatic sphincterotomy and biliary stenting.
Conclusions: EP has been reported to be useful in selected patients with ampullary neoplasms. Data on further long‐term follow up after EP are awaited.</description><subject>Adenoma - diagnosis</subject><subject>Adenoma - pathology</subject><subject>Adenoma - surgery</subject><subject>Ampulla of Vater - pathology</subject><subject>Ampulla of Vater - surgery</subject><subject>ampullary cancer</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Common Bile Duct Neoplasms - diagnosis</subject><subject>Common Bile Duct Neoplasms - pathology</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>endoscopic papillectomy</subject><subject>endoscopic ultrasonography</subject><subject>Endosonography</subject><subject>Humans</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>pancreatic duct stenting</subject><subject>Pancreatic Ducts</subject><subject>Pancreatitis - prevention & control</subject><subject>papilla of the Vater</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prognosis</subject><subject>Sensitivity and Specificity</subject><subject>Sphincterotomy, Endoscopic</subject><subject>Stents</subject><issn>0915-5635</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEFPwkAQhTdGo4j-BbM39VDc2e1u24OHhhYoKS2BInra7JYlAUGQQoR_byvIXGYy894k70MIA2lAWS_zBtg2s0AIaFBSbgkAgcb-AtXOh0tUIx5wiwvGb9BtUcwJAerZ9jW6oWBTj4BdQ2GYBOmwmfajJg4iv52kw2iI_STA2SD0s16YZDhtYb_XH8WxP_jASZj2Y3_Yw0_jKOvgtygI0-c7dDVVi8Lcn3odjVph1uxYcdqOmn5s5bYjwFJKq1wL8ITj6pyq3KHaBmeSU-1NPEOE0BOtmNGuwzjnAiiZEkqZK_jU86aa1dHj8e96s_remWIrl7MiN4uF-jKrXSFd7jouKxOXyoeTcqeXZiLXm9lSbQ7yP3kpeD0KfmYLczjfgciKsJzLCqSsQMqKsPwjLPcyCJNqKv3W0T8rtmZ_9qvNpxQOc7gcJ23ZHbwzyruBpOwXsjB15A</recordid><startdate>201104</startdate><enddate>201104</enddate><creator>Ito, Kei</creator><creator>Fujita, Naotaka</creator><creator>Noda, Yutaka</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201104</creationdate><title>ENDOSCOPIC DIAGNOSIS AND TREATMENT OF AMPULLARY NEOPLASM (WITH VIDEO)</title><author>Ito, Kei ; Fujita, Naotaka ; Noda, Yutaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4761-aabacb619678bc2ac72b417dc2b9d9e066bdba3eb8735556120f0223865f99fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenoma - diagnosis</topic><topic>Adenoma - pathology</topic><topic>Adenoma - surgery</topic><topic>Ampulla of Vater - pathology</topic><topic>Ampulla of Vater - surgery</topic><topic>ampullary cancer</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Common Bile Duct Neoplasms - diagnosis</topic><topic>Common Bile Duct Neoplasms - pathology</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>endoscopic papillectomy</topic><topic>endoscopic ultrasonography</topic><topic>Endosonography</topic><topic>Humans</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>pancreatic duct stenting</topic><topic>Pancreatic Ducts</topic><topic>Pancreatitis - prevention & control</topic><topic>papilla of the Vater</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prognosis</topic><topic>Sensitivity and Specificity</topic><topic>Sphincterotomy, Endoscopic</topic><topic>Stents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ito, Kei</creatorcontrib><creatorcontrib>Fujita, Naotaka</creatorcontrib><creatorcontrib>Noda, Yutaka</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ito, Kei</au><au>Fujita, Naotaka</au><au>Noda, Yutaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ENDOSCOPIC DIAGNOSIS AND TREATMENT OF AMPULLARY NEOPLASM (WITH VIDEO)</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Dig Endosc</addtitle><date>2011-04</date><risdate>2011</risdate><volume>23</volume><issue>2</issue><spage>113</spage><epage>117</epage><pages>113-117</pages><issn>0915-5635</issn><eissn>1443-1661</eissn><abstract>Background and aim: For ampullary cancer, pancreaticoduodenectomy is considered to be the standard treatment. Endoscopic papillectomy (EP) has been utilized in cases of ampullary adenoma since the early 1980s. We aimed to provide a review concerning EP.
Methods: We conducted a review of studies regarding EP for ampullary neoplasms.
Results: Since neither lymphatic permeation, vascular invasion, nor lymph node metastasis is observed in patients with ampullary cancer limited to the mucosa, EP of such tumors without ductal infiltration into the pancreatic/bile duct can be justified as radical treatment. For its application in patients with ampullary neoplasms, accurate pretreatment staging is indispensable. EUS, which can be carried out on an outpatient basis with a low risk of complications, is useful for differential diagnosis as well as detection of periampullary tumors. Although intraductal US of the bile duct tends to result in overestimation of tumor staging in cases of ampullary neoplasm, it can provide useful information for making therapeutic decisions, especially in cases appropriate for EP. While the technical success rate of EP is high, the complication rate and recurrence rate are not as low as a satisfactory level. Pancreatic duct stenting after EP is expected to contribute to prevention of post‐EP pancreatitis. There is no consensus regarding the mode of resection current nor the need for addition of biliary/pancreatic sphincterotomy and biliary stenting.
Conclusions: EP has been reported to be useful in selected patients with ampullary neoplasms. Data on further long‐term follow up after EP are awaited.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21429014</pmid><doi>10.1111/j.1443-1661.2010.01101.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adenoma - diagnosis Adenoma - pathology Adenoma - surgery Ampulla of Vater - pathology Ampulla of Vater - surgery ampullary cancer Cholangiopancreatography, Endoscopic Retrograde Common Bile Duct Neoplasms - diagnosis Common Bile Duct Neoplasms - pathology Common Bile Duct Neoplasms - surgery endoscopic papillectomy endoscopic ultrasonography Endosonography Humans Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - surgery Neoplasm Staging pancreatic duct stenting Pancreatic Ducts Pancreatitis - prevention & control papilla of the Vater Postoperative Complications - prevention & control Prognosis Sensitivity and Specificity Sphincterotomy, Endoscopic Stents |
| title | ENDOSCOPIC DIAGNOSIS AND TREATMENT OF AMPULLARY NEOPLASM (WITH VIDEO) |
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