ENDOSCOPIC PAPILLECTOMY FOR AMPULLARY TUMORS (WITH VIDEOS)

Abstract

In recent years, advances in the endoscopic diagnosis and treatment of pancreaticobiliary diseases have led to the opportunity to detect duodenal ampullary tumors. Endoscopic papillectomy has been widely expanded for the total biopsy and curative treatment of ampullary adenoma. Traditionally, pancreaticoduodenectomy used to be the standard treatment for duodenal ampullary tumors, but reports of endoscopic papillectomy for early ampullary carcinoma have increased recently. However, preoperative diagnosis of early carcinoma is difficult, and postoperative recurrence may occur after an endoscopic papillectomy. Therefore, the indication of endoscopic papillectomy for ampullary carcinoma needs further evaluation. Furthermore, since endoscopic papillectomy carries the risk of possible complications, the endoscopist needs to be familiar with preventive methods and countermeasures for complications, to perform an endoscopic papillectomy efficiently.