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The Long-Term Outcomes of Endoscopic Papillectomy and Management of Cases of Incomplete Resection: A Single-Center Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Endoscopic papillectomy is increasingly performed as an alternative to surgery for early ampullary tumors.

Aim

This retrospective study aimed to evaluate the long-term results of endoscopic papillectomy, the management of cases with incomplete endoscopic resection, and the long-term recurrence rates.

Methods

All 46 patients who underwent endoscopic papillectomy for ampullary tumors between November 2003 and March 2018 were retrospectively evaluated.

Results

The final pathological diagnoses were adenoma (n = 44) and adenocarcinoma (n = 2). Histopathological evaluations after endoscopic papillectomy revealed that complete resection was achieved in 19 patients (19/46, 41.3%). Among the 27 patients with incomplete resection, the margin was histopathologically positive in 14 patients and difficult to evaluate in 13. Additional surgery was performed for 2 of the 14 patients with positive margins. Excluding 2 patients who received additional surgery, 7 of the 25 patients with incomplete resection had recurrence, and 18 had no recurrence during the follow-up period. Ten (77%) of the 13 patients in whom the margin was difficult to evaluate had no recurrence.

Conclusion

Approximately 80% of the patients in whom the histopathological evaluation of the resected margin was difficult had no recurrence even after approximately 5 years of follow-up. Thus, careful observation may be considered for these patients.

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Acknowledgments

We would like to thank Japan Medical Communication for editing the English text of this article.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ward, Okayama, 700-8558, Japan

    Shinichiro Muro, Hironari Kato, Akihiro Matsumi, Yuki Ishihara, Yosuke Saragai, Shuntaro Yabe, Saimon Takata, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi & Hiroyuki Okada

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  1. Shinichiro Muro
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  2. Hironari Kato
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Contributions

M. S. and K. H. designed the study, analyzed the data, and drafted the manuscript; U. D, T. T., and M. K. collected the data; O. H. gave the final approval of the manuscript; all the other authors revised the manuscript and approved the final version of the manuscript.

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Correspondence to Shinichiro Muro.

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The subjects of the present study gave their written informed consent.

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Muro, S., Kato, H., Matsumi, A. et al. The Long-Term Outcomes of Endoscopic Papillectomy and Management of Cases of Incomplete Resection: A Single-Center Study. J Gastrointest Surg 25, 1247–1252 (2021). https://doi.org/10.1007/s11605-020-04532-7

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  • DOI: https://doi.org/10.1007/s11605-020-04532-7

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