Department of Gastroenterology, Turkey High Speciality Training and Research Hospital.
Department of Gastroenterology, Dr. A. Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Surg Laparosc Endosc Percutan Tech. 2020 Jun;30(3):270-275. doi: 10.1097/SLE.0000000000000775.
Endoscopic ampullectomy (EA) offers an insignificantly intrusive strategy for viably treating mucosal and occasionally submucosal lesions of the ampulla of Vater and encompassing periampullary area with high achievement and is more secure. The aim of this study was to present safety, efficacy, and outcomes of EA in the treatment of benign lesions of ampulla Vater performed by single experienced endoscopists in a high volume center.
This retrospective study was conducted in patients referred to our hospital (Turkey High Speciality Training and Research Hospital, Turkey) for endoscopic evaluation of ampullary benign lesions over an 8-year period (between October 2011 and September 2019). Success rate was defined as complete resection of lesions.
Twenty-nine patients with a median age of 64 years were included. Twenty-five patients had lesions confined to the ampulla vateri (86.2%). Accordingly, 2 lesions had intraductal extension adenoma (IDA) (6.9%) and 2 were lateral spreading adenoma (6.9%). The median size of the lesion was 17.5 mm (10 to 36 mm). Nineteen lesions (65.5%) were resected en bloc and 10 lesions (34.5%) were resected in piecemeal manner. Complete resection was achieved in 21 of 23 patients with benign ampullary lesions. The procedure success rate was 91.3%. Complications occurred in 6 patients (20.6%) of these 3 had (10.3%) bleeding, 2 (6.8%) had pancreatitis, and 1 had (3.4%) perforation. Four patients (13.7%) had a recurrence.
Deep resection of the benign ampullary lesions increases the complete resection rate, cannulation rate of the pancreatic duct, and stenting rate of the pancreatic duct. EA is a safe and successful procedure in patients with benign lesions of ampulla vater.
内镜壶腹切除术 (EA) 为治疗 Vater 壶腹的黏膜和偶尔的黏膜下病变以及包含胰胆管周围区域提供了一种微创策略，具有较高的成功率，并且更安全。本研究旨在介绍由单个经验丰富的内镜医生在高容量中心对 Vater 壶腹良性病变进行 EA 治疗的安全性、疗效和结果。
这项回顾性研究纳入了在 8 年期间（2011 年 10 月至 2019 年 9 月）因壶腹部良性病变而在我院（土耳其高级专科培训和研究医院，土耳其）接受内镜评估的患者。成功率定义为病变完全切除。
共纳入 29 例中位年龄为 64 岁的患者。25 例患者的病变局限于 Vater 壶腹（86.2%）。相应地，2 例为腔内延伸性腺瘤（IDA）（6.9%），2 例为侧向扩展性腺瘤（6.9%）。病变的中位大小为 17.5mm（10 至 36mm）。19 例（65.5%）病变整块切除，10 例（34.5%）分块切除。23 例良性壶腹病变中，21 例获得完全切除。手术成功率为 91.3%。6 例（20.6%）患者出现并发症，其中 3 例（10.3%）出血，2 例（6.8%）胰腺炎，1 例（3.4%）穿孔。4 例（13.7%）患者复发。
深度切除良性壶腹病变可提高完全切除率、胰管插管率和胰管支架置入率。EA 是治疗 Vater 壶腹良性病变患者的一种安全且有效的方法。
