Advertisement

Endoscopic Papillectomy

  • Hsiu-Po WangEmail author
Chapter

Abstract

Ampullary tumors include adenoma with/without dysplasia, adenocarcinoma, neuroendocrine tumor, and so on. They may cause clinical symptoms with jaundice, anemia, bleeding, pancreatitis, and duodenal obstruction and are found incidentally by endoscopy for other examination purposes. For the group of patients with familial adenomatous polyposis (FAP), endoscopic surveillance is recommended because of invariably developing duodenal adenomas and a risk for ampullary carcinoma 124-fold greater than the general population [1]. However, in two studies from Japan and the USA, the progression of morphology and histology of the main duodenal papilla was limited in more than 10 years and 4 years follow-up [2, 3]. Because of causing clinical symptoms or malignant potential, removal surgically or endoscopically of the ampullary tumors is the first consideration. Treatments of ampullary tumors include transduodenal local resection, pancreaticoduodenectomy, and endoscopic papillectomy (EP). Pancreaticoduodenectomy (PD) has been considered the standard treatment. Although the mortality associated with PD has decreased in the past decade, morbidity is still high [4]. Transduodenal local resection (surgical ampullectomy) is a less invasive procedure compared with PD. But compared with endoscopic papillectomy (EP), the morbidity is significantly higher. Endoscopic papillectomy was first described in 1983 by Suzuki for two cases with ampullary cancer [5]. EP is now recognized as a less invasive alternative to surgery for ampullary adenomas and is with decreased cost, morbidity and good long-term result [6, 7]. The reported successful rate had been 80–90%. With increase in the aged population with many medical illnesses in each country, EP is considered more frequently than before.

Keywords

Ampullary tumors Ampullary adenoma Endoscopic ultrasound Endoscopic ultrasound elastography Positron emission tomography Intraductal ultrasound Argon plasma coagulation Endoscopic double-snare retracting papillectomy Pancreatic stenting Pancreatic duct Wire-guided endoscopic papillectomy 

References

  1. 1.
    Offerhaus GJ, Giardiello FM, Krush AJ, et al. The risk of upper gastrointestinal cancer in familial adenomatous polyposis. Gastroenterology. 1992;102:1980–2.CrossRefPubMedGoogle Scholar
  2. 2.
    Groves CJ, Saunders BP, Spigelman AD, et al. Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study. Gut. 2002;50:636–41.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Burke CA, Beck GJ, Church JM, et al. The natural history of untreated duodenal and ampullary adenomas in patients with familial adenomatous polyposis followed in an endoscopic surveillance program. Gastrointest Endosc. 1999;49:358–64.CrossRefPubMedGoogle Scholar
  4. 4.
    Chua TC, Saxena A. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg. 2010;14:1442–52.CrossRefPubMedGoogle Scholar
  5. 5.
    Suzuki K, Kantou U, Murakami Y. Two cases with ampullary cancer who underwent endoscopic excision. Prog Dig Endosc. 1983;23:236–9.Google Scholar
  6. 6.
    Napole’on B, Gincul R, Ponchon T, et al. Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicentre prospective study. Endoscopy. 2014;46:127–34.CrossRefGoogle Scholar
  7. 7.
    Yoon SM, Kim MH, Kim MJ, et al. Focal early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy? Gastrointest Endosc. 2007;66:701–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Lee SY, Jang KT, Lee KT, et al. Can endoscopic resection be applied for early stage ampulla of Vater cancer? Gastrointest Endosc. 2006;63:783–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Winter JM, Cameron JL, Olino K, et al. Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis. J Gastrointest Surg. 2010;14(2):379–87.CrossRefPubMedGoogle Scholar
  10. 10.
    Alvarez-Sanchez MV, Oria I, Luna OB, et al. Can endoscopic papillectomy be curative for early ampullary adenocarcinoma of the ampulla of Vater? Surg Endosc. 2017;31(4):1564–72.CrossRefPubMedGoogle Scholar
  11. 11.
    Kim GH, Kim JI, Jeon SW, et al. Korean College of Helicobacter and Upper Gastrointestinal Research. Endoscopic resection for duodenal carcinoid tumors: a multicenter, retrospective study. J Gastroenterol Hepatol. 2014;29(2):318–24.CrossRefPubMedGoogle Scholar
  12. 12.
    Gincul R, Ponchon T, Napoleon B, et al. Endoscopic treatment of sporadic small duodenal and ampullary neuroendocrine tumors. Endoscopy. 2016;48(11):979–86.CrossRefPubMedGoogle Scholar
  13. 13.
    Cheng CL, Sherman S, Fogel EL, et al. Endoscopic snare papillectomy for tumors of the duodenal papillae. Gastrointest Endosc. 2004;60(5):757–64.CrossRefPubMedGoogle Scholar
  14. 14.
    Park JS, Yoon DS, Kim KS, et al. Factors influencing recurrence after curative resection for ampulla of Vater carcinoma. J Surg Oncol. 2007;95(4):286–90.CrossRefPubMedGoogle Scholar
  15. 15.
    Choi SB, Kim WB, Song TJ, et al. Surgical outcomes and prognostic factors for ampulla of Vater cancer. Scand J Surg. 2011;100:92–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Patel R, Davitte J, Varadarajulu S, et al. Endoscopic resection of ampullary adenomas: complications and outcomes. Dig Dis Sci. 2011;56(11):3235–40.CrossRefPubMedGoogle Scholar
  17. 17.
    Heidecke CD, Rosenberg R, Bauer M, et al. Impact of grade of dysplasia in villous adenomas of Vater’s papilla. World J Surg. 2002;26(6):709–14.CrossRefPubMedGoogle Scholar
  18. 18.
    Chini P, Draganov PV. Diagnosis and management of ampullary adenoma: the expanding role of endoscopy. World J Gastrointest Endosc. 2011;3(12):241–7.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Cahen DL, Fockens P, de Wit LT, et al. Local resection or pancreaticoduodenectomy for villous adenoma of the ampulla of Vater diagnosed before operation. Br J Surg. 1997;84(7):948–51.CrossRefPubMedGoogle Scholar
  20. 20.
    Napoleon B, Gincul R, Ponchon T, et al. Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicenter prospective study. Endoscopy. 2014;46(2):127–34.CrossRefPubMedGoogle Scholar
  21. 21.
    Ogawa T, Ito K, Fujita N, et al. Endoscopic papillectomy as a method of total biopsy for possible early ampullary cancer. Dig Endosc. 2012;24(4):291.CrossRefPubMedGoogle Scholar
  22. 22.
    Binmoeller KF, Boaventura S, Ramsperger K, et al. Endoscopic snare excision of benign adenomas of the papilla of Vater. Gastrointest Endosc. 1993;39(2):127–31.CrossRefPubMedGoogle Scholar
  23. 23.
    Ito K, Fujita N, Noda Y, et al. Modes of spread in early ampullary cancer in terms of establishing proper indications for endoscopic papillectomy. Dig Endoscopy. 2004;16:224–8.CrossRefGoogle Scholar
  24. 24.
    Tsuji S, Itoi T, Sofuni A, et al. Tips and tricks in endoscopic papillectomy of ampullary tumors: single-center experience with large case series. J Hepatobiliary Pancreat Sci. 2015;22(6):E22–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Bohnacker S, Seitz U, Nguyen D, et al. Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth. Gastrointest Endosc. 2005;62(4):551–60.CrossRefPubMedGoogle Scholar
  26. 26.
    Geier A, Nguyen HN, Gartung C, et al. MRCP and ERCP to detect small ampullary carcinoma. Lancet. 2000;356:1607–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Mukai H, Yasuda K, Nakajima M. Tumors of the papilla and distal common bile duct. Diagnosis and staging by endoscopic ultrasonography. Gastrointest Endosc Clin N Am. 1995;5:763–72.PubMedGoogle Scholar
  28. 28.
    Kubo H, Chijiiwa Y, Akahoshi K, et al. Pre-operative staging of ampullary tumours by endoscopic ultrasound. Br J Radiol. 1999;72:443–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Hyun JJ, Lee TH, Park JS, et al. A prospective multicenter study of submucosal injection to improve endoscopic snare papillectomy for ampullary adenoma. Gastrointest Endosc. 2017;85(4):746–55.  https://doi.org/10.1016/j.gie.2016.08.013.CrossRefPubMedGoogle Scholar
  30. 30.
    Soma H, Miyata N, Hozawa S, et al. Ampullary adenoma treated by endoscopic double-snare retracting papillectomy. Gut Liver. 2015;9(5):689–92.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Ito K, Fujita N, Noda Y. Endoscopic diagnosis and treatment of ampullary neoplasm (with video). Dig Endosc. 2011;23(2):113–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Norton ID, et al. Safety and outcome of endoscopic snare excision of the major duodenal papilla. Gastrointest Endosc. 2002;56(2):239–43.CrossRefPubMedGoogle Scholar
  33. 33.
    Adler DG, Qureshi W, Davila R, et al. ASGE guideline. The role of endoscopy in ampullary and duodenal adenomas. Gastrointest Endosc. 2006;64:849–54.CrossRefPubMedGoogle Scholar
  34. 34.
    Harewood GC, Pochron NL, Gostout CJ. Prospective, randomized, controlled trial of prophylactic pancreatic stent placement for endoscopic snare excision of the duodenal ampulla. Gastrointest Endosc. 2005;62(3):367–70.CrossRefPubMedGoogle Scholar
  35. 35.
    Desilets DJ, Dy RM, Ku PM, et al. Endoscopic management of tumors of the major duodenal papilla: refined techniques to improve outcome and avoid complications. Gastrointest Endosc. 2001;54:202–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Moon JH, Choi HJ, Lee YN. Current status of endoscopic papillectomy for ampullary tumors. Gut Liver. 2014;8(6):598–604.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Moon JH, Cha SW, Cho YD, et al. Wire-guided endoscopic snare papillectomy for tumors of the major duodenal papilla. Gastrointest Endosc. 2005;61:461–6.CrossRefPubMedGoogle Scholar
  38. 38.
    Lee TY, Cheon YK, Shim CS, et al. Endoscopic wire-guided papillectomy versus conventional papillectomy for ampullary tumors: a prospective comparative pilot study. J Gastroenterol Hepatol. 2016;31(4):897–902.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.National Taiwan University HospitalTaipei CityTaiwan

Personalised recommendations