Advanced endoscopic papillectomy. Issue 2 (17th December 2015)

• Record Type: Journal Article
• Authors: Klein, Amir; Tutticci, Nicholas; Bourke, Michael J
• Is Part Of: Digestive endoscopy. Volume 28:Issue 2(2016)
• Page Start: 121
• Page End: 130
• Publication Date: 2015-12-17
• Subjects: ampullary adenoma -- ampullectomy -- endoscopic mucosal resection -- papillectomy; Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12574
• Languages: English
• ISSNs: 0915-5635

Abstract

Abstract : Historically, neoplasia of the duodenal papilla has been managed surgically, which may be associated with substantial morbidity and mortality. In the absence of invasive cancer, even lesions with extensive lateral duodenal wall involvement, or limited intraductal extension may be cured endoscopically with a superior safety profile. Endoscopic papillectomy is associated with greater risks of adverse events such as bleeding than resection elsewhere in the gastrointestinal tract. Additionally site‐specific complications such as pancreatitis exist. A structured approach to lesion assessment, adherence to technical aspects of resection, endoscopic management of complications and post‐resection surveillance is required. Advances have been made in all facets of endoscopic papillary resection since its introduction in the 1980s; extending the boundaries of endoscopic cure, optimizing outcomes and enhancing patient safety. These will be the focus of the present review.