Endoscopic snare papillectomy for tumors of the duodenal papillae

Cheng, Ching‐Yi; Sherman, Stuart; Fogel, Evan L.; McHenry, Lee; Watkins, James L.; Fukushima, Toyomi; Howard, Thomas J.; Lazzell–Pannell, Laura; Lehman, Glen A.

doi:10.1016/s0016-5107(04)02029-2

Cited by 231 publications

(223 citation statements)

References 34 publications

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“…143 The risk of haemorrhage following ampullectomy ranges from 1% to 7% in published series. [144][145][146][147] No study was found that reported on endoscopic ampullectomy in patients taking aspirin or other antithrombotic agents. Some authors have stated that aspirin can be continued in patients at high thrombotic risk 148 but this should be assessed on an individual patient basis, as bleeding is a common complication and may be severe.…”

Section: Ampullectomymentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines

Vanbiervliet²,

et al. 2017

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Section: Ampullectomymentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines

Vanbiervliet²,

et al. 2017

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“…The role of submucosal injection of saline, which may be combined with epinephrine or methylene blue before ampullectomy, is controversial (6,44,47). Epinephrine and methylene blue may help minimize bleeding and enhance endoscopic visualization of the lesions margins, respectively.…”

Section: Submucosal Injectionmentioning

confidence: 99%

“…Patients diagnosed with an ampullary adenoma have three therapeutic options: pancreaticoduodenectomy, surgical local excision or endoscopic ampullectomy (EA). Endoscopic ampullectomy may be considered in patients with smaller lesions that do not contain invasive carcinoma, and in patients who are poor surgical candidates (4)(5)(6). Many series have reported low morbidity and mortality with endoscopic therapy (4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ampullectomy: A technical review

Espinel¹,

Pinedo²,

Ojeda³

et al. 2015

Rev Esp Enferm Dig

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Background and aim:This article provides a practical review to undertaking safe endoscopic ampullectomy and highlights some of the common difficulties with this technique as well as offering strategies to deal with these challenges.Methods: We conducted a review of studies regarding endoscopic ampullectomy for ampullary neoplasms with special focus on techniques.Results: Accurate preoperative diagnosis and staging of ampullary tumors is imperative for predicting prognosis and determining the most appropriate therapeutic approach. The optimal technique for endoscopic ampullectomy is dependent on the lesions size. En bloc resection is recommended for lesions confined to the papilla. There is no significant evidence to support the submucosal injection before ampullectomy. There is no consensus regarding the optimal current and power output for endoscopic ampulectomy. The benefits of a thermal adjunctive therapy remain controversial. A prophylactic pancreatic stent reduces the incidence and severity of pancreatitis post-ampullectomy.Conclusions: Endoscopic ampullectomy is a safe and efficacious therapeutic procedure for papillary adenomas in experienced endoscopist and it can avoid the need for surgical intervention.

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“…Risk factors for postsphincterotomy bleeding include the presence of hemodialysis, bleeding at the time of the sphincterotomy, active cholangitis, abnormal coagulation status and low endoscopist case volume (less than one case per week) (30,34). In addition, the risk of postprocedural bleeding is higher when an ampullectomy (35) or transmural pseudocyst drainage (36) is performed.…”

Section: Success Ratesmentioning

confidence: 99%