Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth.
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Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth. / Bohnacker, Sabine; Seitz, Uwe; Nguyen, Dzung; Thonke, Frank; Seewald, Stefan; DeWeerth, Andreas; Ponnudurai, Ryan; Omar, Salem; Soehendra, Nib.
in: GASTROINTEST ENDOSC, Jahrgang 62, Nr. 4, 4, 2005, S. 551-560.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth.
AU - Bohnacker, Sabine
AU - Seitz, Uwe
AU - Nguyen, Dzung
AU - Thonke, Frank
AU - Seewald, Stefan
AU - DeWeerth, Andreas
AU - Ponnudurai, Ryan
AU - Omar, Salem
AU - Soehendra, Nib
PY - 2005
Y1 - 2005
N2 - BACKGROUND: Endoscopic papillectomy of benign papillary tumor is still not widely practiced. Intraductal growth has been considered a contraindication for endoscopic therapy. This prospective study evaluates endoscopic papillectomy for treatment of benign papillary tumors without and with intraductal growth. METHODS: Monofilament snare and monopolar electrocoagulation were used for papillectomy. A 7F stent was placed in the pancreatic duct. Patients with distal intraductal growth underwent sphincterotomy and endoscopic resection after exclusion of more proximal growth. RESULTS: Between February 1985 and April 2004, 106 patients (109 lesions), 68 women, 38 men, median age 68 years (range 29-88 years) were included. Median tumor size was 2 cm (range 0.5-6 cm) with one session (range 1-8) required for removal. Nine patients had invasive carcinoma (8%). Surgery for incomplete removal or recurrence was performed in 12% of 75 patients without and 37% of 31 patients with intraductal growth (p <0.01), respectively. Fifteen patients had recurrence (15%); but, only 4 required surgery. Endoscopic resection was curative (median follow-up, 43 months) in 83% without and 46% with intraductal growth (p <0.001). CONCLUSIONS: Endoscopic papillectomy is safe and effective, and may be feasible in cases of intraductal growth. Surveillance and, if required, re-treatment are mandatory because of the risk of recurrence.
AB - BACKGROUND: Endoscopic papillectomy of benign papillary tumor is still not widely practiced. Intraductal growth has been considered a contraindication for endoscopic therapy. This prospective study evaluates endoscopic papillectomy for treatment of benign papillary tumors without and with intraductal growth. METHODS: Monofilament snare and monopolar electrocoagulation were used for papillectomy. A 7F stent was placed in the pancreatic duct. Patients with distal intraductal growth underwent sphincterotomy and endoscopic resection after exclusion of more proximal growth. RESULTS: Between February 1985 and April 2004, 106 patients (109 lesions), 68 women, 38 men, median age 68 years (range 29-88 years) were included. Median tumor size was 2 cm (range 0.5-6 cm) with one session (range 1-8) required for removal. Nine patients had invasive carcinoma (8%). Surgery for incomplete removal or recurrence was performed in 12% of 75 patients without and 37% of 31 patients with intraductal growth (p <0.01), respectively. Fifteen patients had recurrence (15%); but, only 4 required surgery. Endoscopic resection was curative (median follow-up, 43 months) in 83% without and 46% with intraductal growth (p <0.001). CONCLUSIONS: Endoscopic papillectomy is safe and effective, and may be feasible in cases of intraductal growth. Surveillance and, if required, re-treatment are mandatory because of the risk of recurrence.
M3 - SCORING: Zeitschriftenaufsatz
VL - 62
SP - 551
EP - 560
JO - GASTROINTEST ENDOSC
JF - GASTROINTEST ENDOSC
SN - 0016-5107
IS - 4
M1 - 4
ER -
