Wire-guided endoscopic snare papillectomy for tumors of the major duodenal papilla

Moon, Jong Ho; Woo, Seung Kyoon; Cho, Young Deok; Ryu, Chang Beom; Cheon, Young Koog; Kwon, Kye Won; Kim, Young Seok; Kim, Yun Soo; Lee, Joon Seong; Lee, Moon Sung; Shim, Chan Sup; Kim, Boo Sung

doi:10.1016/s0016-5107(04)02649-5

Cited by 58 publications

(36 citation statements)

References 18 publications

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“…The most serious complications are perforation, bleeding, and pancreatitis and all are potentially lethal in their most severe forms [15][16][17]. Identification of high-risk patients, early recognition of complications, and aggressive management ameliorates their frequency and severity.…”

Section: Complications and Managementmentioning

confidence: 99%

“…This is the most frequent complication as the duodenum is highly vascular and is thus at high risk of both early and delayed bleeding, particularly with resection of extensive and laterally spreading lesions [7][8][9][10][11][12][13][14][15][16][17][18]. Delayed bleeding is common and should in general be managed as for bleeding after endoscopic sphincterotomy.…”

Section: Bleedingmentioning

confidence: 99%

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Endoscopic ampullectomy

Bourke

2014

Ercp

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Section: Complications and Managementmentioning

confidence: 99%

Section: Bleedingmentioning

confidence: 99%

Endoscopic ampullectomy

Bourke

2014

Ercp

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“…If there is a residual, this is generally diminutive and easily excised (or ablated if excision is not possible). 5,18,19 Subsequent to that endoscopy with a side viewing endoscope is repeated annually for the next three to five years, with direct visualization and biopsy of the site, with surveillance intervals gradually lengthening subsequent to that.…”

Section: Thermal Ablationmentioning

confidence: 99%

Endoscopic ampullectomy: A practical guide

Bassan¹,

Bourke²

2012

jig

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Abbreviations: CBD: common bile duct; ERCP: endoscopic retrograde cholangio-pancreatography; EUS: endoscopic ultrasound; IDE: intraductal extension; LST-P: laterally spreading tumor of the papilla; MRCP: magnetic resonance cholangiopancreatography; PD: pancreatic ductEndoscopic ampullectomy is a minimally invasive method of treating superficial lesions of the ampulla of Vater. With careful patient selection and lesion assessment it is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention. Strategies for safe and successful endoscopic ampullectomy with a focus on resection technique and recognition and management of complications are presented.

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“…We attempted to per− form a wire−guided endoscopic snare re− section using the previously reported method for adenomas of the major papil− la [4]. En bloc resection was successfully achieved without any procedure−related complications or residual tumor.…”

mentioning

confidence: 99%

“…Itoi et al [3] performed a balloon−cathe− ter−assisted endoscopic snare resection using a double−channel duodenoscope for choledochocele. We attempted to per− form a wire−guided endoscopic snare re− section using the previously reported method for adenomas of the major papil− la [4]. En bloc resection was successfully achieved without any procedure−related complications or residual tumor.…”

mentioning

confidence: 99%

Wire-guided endoscopic snare resection of a choledochocele-associated villous adenoma

Park

Lee²,

Kim³

et al. 2009

Endoscopy

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Adenomas arising in a choledochocele are usually resected surgically because they are difficult to completely remove endo− scopically and they are associated with a high malignancy potential [1 ± 2]. We successfully performed an endoscopic snare resection for choledochocele−asso− ciated villous adenoma with high−grade dysplasia.A 76−year−old woman was admitted com− plaining of epigastric pain lasting for sev− eral days. Duodenoscopy revealed a soft cystic−mass−like lesion covered with nor− mal mucosa above the ampulla of Vater (l " Fig. 1). Intraductal ultrasound showed an an− echogenic cystic mass with diffuse wall thickening and preserved wall layer (l " Fig. 2). Magnetic resonance cholangiopancrea− tography showed an oval−shaped cystic mass above the ampulla of Vater. A major endoscopic sphincterotomy was conduct− ed. Following sphincterotomy, duodenos− copy revealed mucosal nodules on the in− ner surface of the choledochocele (l " Fig. 3). Histopathologic findings of the biopsy specimen showed an adenoma with high−grade dysplasia (l " Fig. 4). Because the patient wanted to undergo an endoscopic treatment, we performed a wire−guided endoscopic snare resection for the choledochocele with the adenoma (l " Fig. 5, l " Video 1).During the 1−year follow−up duodenosco− py, no remnant or recurrence of the ade− noma was found. The surgical approach may be too inva− sive for a choledochocele with adenoma. Itoi et al.[3] performed a balloon−cathe− ter−assisted endoscopic snare resection using a double−channel duodenoscope for choledochocele. We attempted to per− form a wire−guided endoscopic snare re− section using the previously reported method for adenomas of the major papil− la [4]. En bloc resection was successfully achieved without any procedure−related complications or residual tumor. In con− clusion, endoscopic snare resection may be a feasible and effective solution for se− lected patients with choledochocele asso− ciated with a villous adenoma. Endoscopy_UCTN_Code_CCL_1AZ_2AK Endoscopy_UCTN_Code_TTT_1AR_2AKWire−guided endoscopic snare resection of a choledochocele−associated villous adenoma Video 1Wire−guided endoscopic snare resection. The guide wire was inserted into the main pancre− atic duct. An electrosurgical snare was then inserted along the guide wire. The snare was manipulated to grasp the base of the chole− dochocele before en bloc resection was con− ducted. After the excision had been complet− ed, a pancreatic stent was immediately placed along the indwelling guide wire. Histopatholo− gic examination of the resected specimen showed a villous adenoma with a clear resec− tion margin (l " Fig. 6). This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. UCTN ± Unusual cases and technical notes

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Wire-guided endoscopic snare papillectomy for tumors of the major duodenal papilla

Cited by 58 publications

References 18 publications

Endoscopic ampullectomy

Endoscopic ampullectomy

Endoscopic ampullectomy: A practical guide

Wire-guided endoscopic snare resection of a choledochocele-associated villous adenoma

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