A Survey of Ampullectomy Practices

Menees, Stacy B.; Schoenfeld, Philip; Elta, Grace H.

doi:10.1016/j.gie.2007.03.454

Cited by 7 publications

(12 citation statements)

References 31 publications

(61 reference statements)

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“…Though endoscopic resection of these tumors has been practiced for more than twenty years, there is not yet consensus on the upper limit of the size of tumors suitable for endoscopic resection, the preprocedural staging protocol (endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), intra-ductal ultrasonography (IDUS), contrast enhanced computed tomography (CECT), magnetic resonance imaging (MRI)), technique of papillectomy, need for biliary sphincterotomy, or timing of pancreatic stent placement and follow-up of patients after resection. 5,6 Although endoscopic resection is safer than surgery, it still carries the risk of early complications like bleeding (2-15%), perforation (0-4%), cholangitis (0-2%) and acute pancreatitis (8-15%), as well as late complications like papillary stenosis (0-8%). 7,8 Researchers are constantly striving to develop technology and techniques to prevent, minimize or effectively handle these complications.…”

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confidence: 99%

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Changing disease burden of hepatocellular carcinoma in the Far East and Southeast Asia

Kao

Chen

2005

Liver International

104

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Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world, and has a marked difference in geographic distribution. More than 80% of HCC cases occur in developing countries, especially the Far East and Southeast Asia. Although immunization has been successful against hepatitis B virus (HBV), a changing disease burden of HCC has been observed in many parts of the world because of the increasing prevalence and duration of hepatitis C virus (HCV) infection in these countries. In addition, the age-specific incidence of HCC has progressively shifted toward younger people. Hepatitis B genotypes B and C are prevalent in the Far East and Southeast Asia, and the clinical relevance of HBV genotypes has become increasingly recognized. Compared with genotype C, genotype B is associated with earlier hepatitis B e antigen seroconversion, slower progression to cirrhosis and less frequent development of HCC. By using periodic examinations of serum alfa-fetoprotein levels and abdominal ultrasonography, small HCC can be detected and treated earlier. However, prevention of HBV and HCV infections as well as effective treatment of the chronic viral infections with timely interventions are still needed for the global control of HCC, particularly in the Far East and Southeast Asia.

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confidence: 99%

“…Most endoscopists place a small stent (3-5 Fr) for a short period (3 days). 5,12 Some keep the stent in situ until the next surveillance endoscopy (1-2 months) as the pancreatic stent may protect the organ from pancreatitis if resection or thermal ablation is required.…”

mentioning

confidence: 99%

Changing disease burden of hepatocellular carcinoma in the Far East and Southeast Asia

Kao

Chen

2005

Liver International

104

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“…Historically, surgery was the preferred approach but now endoscopy has been shown to be a good alternative first line therapy. Though endoscopic resection of these tumors has been practiced for more than twenty years, there is not yet consensus on the upper limit of the size of tumors suitable for endoscopic resection, the preprocedural staging protocol (endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), intra‐ductal ultrasonography (IDUS), contrast enhanced computed tomography (CECT), magnetic resonance imaging (MRI)), technique of papillectomy, need for biliary sphincterotomy, or timing of pancreatic stent placement and follow‐up of patients after resection 5,6 …”

mentioning

confidence: 99%

“…There is, however, no consensus on the type of stent that should be used or the optimal duration of placement. Most endoscopists place a small stent (3–5 Fr) for a short period (3 days) 5,12 . Some keep the stent in situ until the next surveillance endoscopy (1–2 months) as the pancreatic stent may protect the organ from pancreatitis if resection or thermal ablation is required.…”

mentioning

confidence: 99%

“…Data indicate that there are problems associated with both pre‐ and post‐procedure stenting. Pre‐procedure stenting may interfere with en bloc resection of the tumor resulting in piecemeal resection along the stent; this would hinder complete excision and make precise histopathological examination of the tumor difficult 5 . On the other hand, post‐papillectomy stenting is technically difficult because the pancreatic orifice is often difficult to identify and cannulate as it may be buried within the coagulum at the base of the tumor 9 .…”

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confidence: 99%

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Endoscopic resection of ampullary adenomas: Novel technique to reduce post procedure pancreatitis

Chacko

Dutta

2010

J of Gastro and Hepatol

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Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2021

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Main Recommendations 1 ESGE recommends against diagnostic/therapeutic papillectomy when adenoma is not proven.Strong recommendation, low quality evidence. 2 ESGE recommends endoscopic ultrasound and abdominal magnetic resonance cholangiopancreatography (MRCP) for staging of ampullary tumors.Strong recommendation, low quality evidence. 3 ESGE recommends endoscopic papillectomy in patients with ampullary adenoma without intraductal extension, because of good results regarding outcome (technical and clinical success, morbidity, and recurrence).Strong recommendation, moderate quality evidence. 4 ESGE recommends en bloc resection of ampullary adenomas up to 20–30 mm in diameter to achieve R0 resection, for optimizing the complete resection rate, providing optimal histopathology, and reduction of the recurrence rate after endoscopic papillectomy.Strong recommendation, low quality evidence. 5 ESGE suggests considering surgical treatment of ampullary adenomas when endoscopic resection is not feasible for technical reasons (e. g. diverticulum, size > 4 cm), and in the case of intraductal involvement (of > 20 mm). Surveillance thereafter is still mandatory.Weak recommendation, low quality evidence. 6 ESGE recommends direct snare resection without submucosal injection for endoscopic papillectomy.Strong recommendation, moderate quality evidence. 7 ESGE recommends prophylactic pancreatic duct stenting to reduce the risk of pancreatitis after endoscopic papillectomy.Strong recommendation, moderate quality evidence. 8 ESGE recommends long-term monitoring of patients after endoscopic papillectomy or surgical ampullectomy, based on duodenoscopy with biopsies of the scar and of any abnormal area, within the first 3 months, at 6 and 12 months, and thereafter yearly for at least 5 years.Strong recommendation, low quality evidence.

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A Survey of Ampullectomy Practices

Cited by 7 publications

References 31 publications

Changing disease burden of hepatocellular carcinoma in the Far East and Southeast Asia

Changing disease burden of hepatocellular carcinoma in the Far East and Southeast Asia

Endoscopic resection of ampullary adenomas: Novel technique to reduce post procedure pancreatitis

Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

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