Abstract
Although the treatment for tumor of the papilla of Vater is basically a surgical operation, endoscopic papillectomy (EP) has been newly developing in recent years. While it is agreed on its indication for adenomas without extension into bile duct or pancreatic duct, opinions vary on its extended application to early-stage cancer.
Understanding of the particular anatomy of the papillary region is indispensable in diagnosing tumors of the papilla of Vater. For diagnosing the tumor extent, not only by determination of tumor invasion of duodenal wall (Du) and pancreas (Panc), but also the evaluation of bile duct and pancreatic duct extension by using EUS and IDUS is required. EP is technically difficult with high risk of complication, should be performed only by expert therapeutic endoscopists and management of pancreatitis and bleeding is particularly important.
In this technical note, we would like to show how to manage imaging diagnosis and EP for tumor of the papilla of Vater.
