Abstract
We have been performing endoscopic snare excision for major duodenal papilla tumors in our institution since October 2002. In patients with adenoma of the papilla, endoscopic snare excision is indicated for complete removal of the tumor. Endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and intraductal ultrasound were useful for determining the depth of tumor invasion before initiating endoscopic treatment. However, major complications of endoscopic techniques include postoperative pancreatitis and cholangitis. Here, we describe our procedure designed to reduce the occurrence of such complications. All patients recovered with 1 week after the surgery without complications. Long-term outcomes showed good results for adenoma and carcinoma in adenoma. However, 40% of patients with adenocarcinoma experienced tumor recurrence. We consider endoscopic snare excision for adenomas of the major duodenal papilla to be a safe and useful treatment.
