Long-term Follow-up of Endoscopic Papillectomy and the Value of Preventive Pancreatic Stent Placement (with Videos)

Overview

Journal Gastroenterol Rep (Oxf)

Specialty Gastroenterology

Date 2023 Oct 23

PMID 37867926

Authors

Yuling Wang

Xiaoqing Zhang

Zhenhua Yang

Teng Wang

Dongqing Zhu

Jie Gao

Ping-Ping Zhang

Peiqin Wang

Xingang Shi

Affiliations

Soon will be listed here.

Abstract

Background: Early-stage ampullary adenomas have only been reported in a small case series on endoscopic management. Hence, this study aimed to evaluate the long-term outcomes of early ampullary adenoma with endoscopic management and identify the risk factors for acute pancreatitis after endoscopic papillectomy (EP).

Methods: In this study, 115 patients who underwent EP at Changhai Hospital (Shanghai, China) between January 2012 and December 2018 were retrospectively analysed. Endoscopy was performed at 1, 3, 6, and 12 months after EP. Data were statistically analysed using the -test or the Mann-Whitney test.

Results: A total of 107 patients were included in this study and the follow-up period was 75 ± 43 months. The average age of the 107 patients was 54.6 years and the average tumor size was 17 mm. The average age of the patients (53.7 ± 10.7 years vs 55.2 ± 10.5 years, =0.482), minimum tumor size (13 vs 19 mm, =0.063), and complete resection rate (84.78% vs 85.25%, =0.947) did not differ significantly between the stent placement and non-stent placement groups. Post-EP acute pancreatitis rates in the non-stent placement and stent placement groups were 11.48% and 4.35%, respectively. The risk of post-EP acute pancreatitis was significantly associated with the preoperative carcinoembryonic antigen level in univariate analysis, but not in multivariate analysis. The risk of post-EP acute pancreatitis was not significantly associated with the placement of the pancreatic stent in either univariate or multivariate analysis. Moreover, delayed proximal pancreatic duct stenosis was not noted in either group during long-term follow-up.

Conclusions: EP is a satisfactory option for treating adenomas of the ampulla of the duodenum.

Citing Articles

Instant duodenal decompression after endoscopic retrograde cholangiopancreatography can effectively reduce the incidence of post-ERCP pancreatitis and hyperamylasemia.

Bi Y, Yan S, Zhou L, Sun Y, Zhang J Gastroenterol Rep (Oxf). 2024; 12:goae025.

PMID: 38586538 PMC: 10997411. DOI: 10.1093/gastro/goae025.

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