New Endoscopic Strategy for Ampullary Tumor and Superficial Nonampullary Duodenal Epithelial Tumor Extending Into Papillary Area.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-06-09 DOI:10.1002/jhbp.12165

Takashi Hirose, Yoshihisa Takada, Kazuhiro Furukawa, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Masanao Nakamura, Hiroki Kawashima

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引用次数: 0

Abstract

Background and study aim: Endoscopic papillectomy (EP) is widely performed for avoiding high-risk surgeries. However, recurrence rates are high, and lateral extension is a risk for recurrence. With endoscopic submucosal dissection (ESD), even lesions with lateral extensions are able to be en bloc resected, and may reduce that risk. The aim of this study is to validate the adequacy and safety of the new strategy.

Patients and methods: This is an exploratory observational study with prospective case enrollment and retrospective analysis.

Inclusion criteria: patients aged 20-85 years with a diagnosis of ampullary tumor or superficial nonampullary duodenal epithelial tumors extending into papilla, and endoscopically resected between December 2020 and April 2023. EP was performed with a lateral extension of < 20 mm, and ESD was performed with 20 mm or more, and the validity of these strategies was verified.

Results: In total, 40 patients were enrolled, 29 EP and 11 ESD underwent. The en bloc resection rate was 95% (38/40) and endoscopic control was 97.5% (39/40). Adverse events were observed in 27.5% (11/40), with no significant difference in both groups. No serious adverse event was observed.

Conclusions: This strategy based on lateral extension performed very well, and ESD is a useful treatment.

查看原文本刊更多论文

壶腹部肿瘤及扩展至乳头区十二指肠浅表性上皮肿瘤的内镜新策略。

背景与研究目的：内镜下乳头切除术（EP）被广泛应用于避免高危手术。然而，复发率高，外侧延伸是复发的风险。通过内镜下粘膜下剥离（ESD），即使有外侧延伸的病变也可以全部切除，并且可以降低这种风险。本研究的目的是验证新策略的充分性和安全性。患者和方法：这是一项前瞻性病例登记和回顾性分析的探索性观察研究。纳入标准：年龄20-85岁，诊断为壶腹肿瘤或浅表性非壶腹十二指肠上皮肿瘤，并延伸至乳头，于2020年12月至2023年4月经内镜切除的患者。结果：共纳入40例患者，其中EP 29例，ESD 11例。整体切除率为95%(38/40)，内镜下控制率为97.5%（39/40）。不良事件发生率为27.5%(11/40)，两组比较差异无统计学意义。未观察到严重的不良事件。结论：以侧伸为基础的手术策略效果良好，ESD是一种有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.