ENDOSCOPIC MANAGEMENT OF AMPULLARY NEOPLASMS

Abstract

The detection rate of ampullary adenomas has increased because of the widespread use of endoscopic screening. Conventionally, laparotomic pancreaticoduodenectomy has been recommended for advanced ampullary adenocarcinoma. However, the management of early asymptomatic ampullary tumors has changed from open surgery to endoscopic resection because of the developed endoscopic techniques and devices. Endoscopic papillectomy is a widespread therapeutic modality for ampullary tumors despite its high-risk endoscopic technique. Japan Gastroenterological Endoscopy Society and European Society of Gastrointestinal Endoscopy published new guidelines, presenting current best practices of endoscopic papillectomy, despite insufficient evidence. This article reviews more recent emerging evidences and offers tips that can help in actual clinical practice.