Advantage of endoscopic papillectomy for ampullary tumors as an alternative treatment for pancreatoduodenectomy.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
07 09 2022
07 09 2022
Historique:
received:
12
03
2022
accepted:
29
08
2022
entrez:
7
9
2022
pubmed:
8
9
2022
medline:
11
9
2022
Statut:
epublish
Résumé
Endoscopic papillectomy for early ampullary tumors is considered a minimally invasive and useful alternative to pancreatoduodenectomy; however, its indications remain unclear. This study aimed to clarify the advantages of endoscopic papillectomy by investigating the clinical outcomes of patients who underwent endoscopic papillectomy or pancreatoduodenectomy for early ampullary tumors. Patients diagnosed with early ampullary tumors (adenoma, Tis, T1a) who underwent endoscopic papillectomy or pancreatoduodenectomy between June 2008 and October 2019 were included, and their clinical outcomes were analyzed. Seventy-four patients (34 patients with adenomas and 40 patients with adenocarcinomas) were divided into two groups, namely endoscopic papillectomy (n = 43) and pancreatoduodenectomy (n = 31). The estimated 5-year overall survival rate of all early ampullary tumors was 92%. Complete resection rate was significantly lower for endoscopic papillectomy patients versus pancreatoduodenectomy patients (48.8% vs. 100%; p < 0.001). Recurrence was more common in the endoscopic papillectomy group compared to the pancreatoduodenectomy group (16.3% vs. 3.2%; p = 0.128), but all recurrences were controllable by endoscopic treatment. The median length of hospital stay for the endoscopic papillectomy group was significantly shorter compared to the endoscopic papillectomy group (11 days vs. 42 days; p < 0.001). The Comprehensive Complication Index was significantly lower in the endoscopic papillectomy group compared to the pancreatoduodenectomy group (14.8 vs 22.6%; p = 0.002). Endoscopic papillectomy for early ampullary tumors is useful and may be an alternative treatment for pancreatoduodenectomy in selected cases.
Identifiants
pubmed: 36071180
doi: 10.1038/s41598-022-19439-3
pii: 10.1038/s41598-022-19439-3
pmc: PMC9452518
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
15134Informations de copyright
© 2022. The Author(s).
Références
Am Surg. 1997 Jun;63(6):467-71
pubmed: 9168753
Gut. 2013 Jan;62(1):102-11
pubmed: 23100216
Gastrointest Endosc. 2017 Jan;85(1):32-47
pubmed: 27546389
Gastrointest Endosc. 2007 Oct;66(4):701-7
pubmed: 17905011
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
CA Cancer J Clin. 2017 Mar;67(2):93-99
pubmed: 28094848
J Gastroenterol Hepatol. 2021 Aug;36(8):2315-2323
pubmed: 33604986
Arch Pathol Lab Med. 2014 Aug;138(8):1072-6
pubmed: 25076296
Gastrointest Endosc. 1993 Mar-Apr;39(2):127-31
pubmed: 8495831
Biosci Trends. 2017 Jan 16;10(6):507-511
pubmed: 27990004
Anticancer Res. 2017 Sep;37(9):5277-5283
pubmed: 28870965
World J Gastroenterol. 2019 Mar 21;25(11):1387-1397
pubmed: 30918431
Gastrointest Endosc Clin N Am. 2003 Oct;13(4):649-69
pubmed: 14986792
Surgery. 2005 Jul;138(1):8-13
pubmed: 16003309
World J Surg. 1999 Feb;23(2):164-71; discussion 171-2
pubmed: 9880426
World J Gastroenterol. 2015 Jul 14;21(26):7970-87
pubmed: 26185369
Ann Surg. 2013 Jul;258(1):1-7
pubmed: 23728278
Endoscopy. 2021 Apr;53(4):429-448
pubmed: 33728632
Rev Esp Enferm Dig. 2016 May;108(5):271-8
pubmed: 27187501
Dig Endosc. 2019 Mar;31(2):188-196
pubmed: 30161275
World J Gastrointest Endosc. 2015 Aug 10;7(10):987-94
pubmed: 26265992
Surgery. 2007 Jul;142(1):20-5
pubmed: 17629996
Ann Surg. 1997 Sep;226(3):248-57; discussion 257-60
pubmed: 9339931
Dig Endosc. 2021 Jul;33(5):858-869
pubmed: 33107134
Surgery. 2018 May;163(5):1071-1079
pubmed: 29452703