Endoscopic snare papillectomy: a possible radical treatment for a subgroup of T1 ampullary adenocarcinomas

Endoscopy. 2013;45(5):401-4. doi: 10.1055/s-0032-1326213. Epub 2013 Apr 24.

Abstract

Pancreaticoduodenectomy is the standard care for invasive ampullary adenocarcinomas. However, endoscopic snare papillectomy (ESP) might play a curative role in very selected patients. We studied a series of 15 patients with T1 ampullary adenocarcinoma who were treated by ESP alone and followed up for a mean of 29.6 ± 21.9 months (range 8 - 81 months). ESP was curative for eight patients (57.1 %). No tumor-related death was observed in patients with a cancer infiltration depth of ≤ 4 mm. According to this preliminary experience, we suggest that this measurable variable threshold should be considered as a possible basis for future large-scale studies.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery*
  • Aged
  • Aged, 80 and over
  • Ampulla of Vater*
  • Common Bile Duct Neoplasms / pathology*
  • Common Bile Duct Neoplasms / surgery*
  • Disease-Free Survival
  • Duodenoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / surgery*
  • Retrospective Studies