Updates in endoscopic management of ampullary and duodenal adenomas.
Journal
Current opinion in gastroenterology
ISSN: 1531-7056
Titre abrégé: Curr Opin Gastroenterol
Pays: United States
ID NLM: 8506887
Informations de publication
Date de publication:
01 11 2023
01 11 2023
Historique:
medline:
10
10
2023
pubmed:
9
10
2023
entrez:
9
10
2023
Statut:
ppublish
Résumé
Adenomas are the most common benign lesions of the gastrointestinal tract. The current review aims to summarize recent literature regarding risk factors, natural history, diagnostic and staging technique, and management strategies for ampullary and nonampullary duodenal adenomas. Recent studies identified several possible risks factors for duodenal adenomas (e.g., cholecystectomy, proton pump inhibitor use), although these associations require corroboration. Chromoendoscopy and endocystoscopy may offer accuracy comparable to biopsies in expert hands. Recent publications underscore the reduction in morbidity with endoscopic resection for lesions without signs of malignancy with submucosal invasion. Submucosal injection did not improve safety of endoscopic ampullectomy. Surveillance may be a reasonable strategy for sub-centimeter ampullary adenomas occurring in familial adenomatous polyposis, as they carry a relatively low risk of malignancy. Endoscopic resection is the preferred strategy over surgery in patients without lesions suggestive of invasive malignancy. For nonampullary duodenal adenomas, several endoscopic resection techniques are available, each with their unique advantages and trade-offs. In patients who are not operative candidates but have intraductal extension, endoscopic ablation is an emerging option.
Identifiants
pubmed: 37807962
doi: 10.1097/MOG.0000000000000976
pii: 00001574-202311000-00008
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
496-502Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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