Endoscopic snare excision for a major papilla tumor

Abstract

Tumors of the duodenal papilla include hyperplasia, adenoma, carcinoma in adenoma and carcinoma. As the duodenal papilla has special anatomical characteristics and treatment involves major intervention and correct preoperative diagnosis. In patients with adenoma, or early carcinoma of the papilla, various endoscopic snare excision techniques are indicated for complete removal the tumor. Pancreatitis and cholangitis are major complications caused by endoscopic techniques. In the present study, endoscopic snare excision of the tumor located at the major papilla was carried out in two cases with early carcinoma or adenoma patients using a therapeutic duodenoscope, a spiral snare for the colon, and pure cutting current. The patients who underwent insertion of a 5-Fr pancreatic stent and a 7-Fr biliary stent inserted immediately after endoscopic tumor resection did not develop either pancreatitis nor cholangitis. This seems to be a safe technical method to prevent complications of endoscopic snare excision of the major papilla tumor.Key words: biliary stenting, endoscopic snare excision of a major papilla tumor, pancreatic stenting.

Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors

“…In recent years, advances in endoscopic diagnosis and treatment of pancreaticobiliary diseases have led to the endoscopic treatment of duodenal ampullary tumors. [1][2][3][4][5][6][7] Most duodenal ampullary tumors are derived from adenomas or carcinomas; however, adenomas are considered precancerous lesions that may become carcinomas through an adenoma-carcinoma sequence. 8,9 Thus, complete resection is essential for radical treatment.…”

Endoscopic Snare Excision of a Major Duodenal Papillary Tumor

“…In recent years, endoscopic papillectomy has been performed to achieve complete resection of adenomas [3,4]. A number of endoscopic resection techniques for tumors of the major papilla have been introduced together with instruments developed for these purposes [5,6]. Such techniques can result in serious complications, such as bleeding and postoperative pancreatitis or postoperative cholangitis.…”