Clinical Impact of Piecemeal Resection Concerning the Lateral Spread of Ampullary Adenomas

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Author(s)

    • Yamamoto Kenjiro
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Fujita Mitsuru
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Asai Yasutsugu
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Itoi Takao
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Sofuni Atsushi
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Ishii Kentaro
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Tsuji Shujiro
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Tanaka Reina
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Tonozuka Ryosuke
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Honjo Mitsuyoshi
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
    • Mukai Shuntaro
    • Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan

Abstract

<p><b>Objective </b>Endoscopic papillectomy (EP) has been recognized to be a safe and reliable treatment modality for ampullary adenomas. The purpose of this study was to determine the safety and efficacy of endoscopic piecemeal resection for laterally spreading ampullary adenomas and to compare these findings with a control population of smaller conventional ampullary tumors treated in the same time period. </p><p><b>Methods </b>Between May 1999 and September 2015, 136 patients underwent EP at Tokyo Medical University hospital. A total of 125 patients underwent en bloc resection, and 11 patients underwent piecemeal resection. </p><p><b>Results </b>The final pathological diagnoses were 103 adenomas, 14 carcinomas in adenomas, 4 carcinomas, and 4 hyperplasia in the en bloc resection group, versus 7 adenomas, 3 carcinomas in adenoma, and 1 carcinomas in the piecemeal resection group. A single treatment session was possible in 104 (83.2%) of the 125 patients in the en bloc resection group and in 8 (72.7%) of the 11 in the piecemeal resection group. The total resection rate including additional treatments was 98.4% in the en bloc resection group and 100% in the piecemeal resection group. </p><p><b>Conclusion </b>Piecemeal resection for laterally spreading ampullary adenomas was sufficiently performed compared with en bloc resection. </p>

Journal

  • Internal Medicine

    Internal Medicine 58(7), 901-906, 2019

    The Japanese Society of Internal Medicine

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