Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan. igarashi @ med.toho-u.ac.jp
Dig Surg. 2010;27(2):119-22. doi: 10.1159/000286715. Epub 2010 Jun 10.
BACKGROUND/AIMS: Tumors of the duodenal papilla include hyperplasia, adenoma, carcinoma in adenoma, and carcinoma. Since the duodenal papilla has special anatomical characteristics and treatment involves major intervention, a correct preoperative diagnosis is essential for successful treatment.
In patients with adenoma or early carcinoma of the papilla, endoscopic snare excision is indicated for complete removal of the tumor. Postoperative pancreatitis and cholangitis are major complications of endoscopic techniques, and we describe here in detail our procedure aiming to reduce the incidence of such complications.
Endoscopic snare excision of a tumor of the major duodenal papilla was carried out in 36 patients. Bleeding after endoscopic excision occurred in 6 cases (17%), postoperative pancreatitis in 11 cases (30%), and postoperative cholecystitis in 1 case (3%). All patients recovered from the complications within 1 week.
Our results suggest that the procedure for endoscopic snare excision used to resect major papillary tumors is safe and helps to prevent serious complications.
背景/目的：十二指肠乳头肿瘤包括增生、腺瘤、腺瘤内癌和癌。由于十二指肠乳头具有特殊的解剖学特征，且治疗需要进行重大干预，因此正确的术前诊断对于成功治疗至关重要。
对于患有乳头腺瘤或早期癌的患者，内镜套扎切除术适用于完全切除肿瘤。术后胰腺炎和胆管炎是内镜技术的主要并发症，我们在这里详细描述了旨在降低这些并发症发生率的操作步骤。
36 例患者行十二指肠乳头大肿瘤的内镜套扎切除术。内镜切除后出血 6 例（17%），术后胰腺炎 11 例（30%），术后胆囊炎 1 例（3%）。所有患者均在 1 周内恢复并发症。
我们的结果表明，用于切除主要乳头肿瘤的内镜套扎切除术是安全的，并有助于预防严重并发症。
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