壶腹肿瘤的内镜下乳头切除术和经十二指肠壶腹切除术适应证的研究。
Investigation of the Indications for Endoscopic Papillectomy and Transduodenal Ampullectomy for Ampullary Tumors.
作者信息
Sekine Masanari, Watanabe Fumiaki, Ishii Takehiro, Miura Takaya, Koito Yudai, Kashima Hitomi, Matsumoto Keita, Noda Hiroshi, Rikiyama Toshiki, Mashima Hirosato
机构信息
Saitama Medical Center, Department of Gastroenterology, Jichi Medical University, Saitama 330-8503, Japan.
Saitama Medical Center, Department of Surgery, Jichi Medical University, Saitama 330-8503, Japan.
出版信息
J Clin Med. 2021 Sep 28;10(19):4463. doi: 10.3390/jcm10194463.
OBJECTIVE
The standard treatment for ampullary tumors is pancreaticoduodenectomy. However, minimally invasive procedures such as endoscopic papillectomy (EP) and transduodenal ampullectomy (TDA) have recently gained popularity. Therefore, we aimed to evaluate the effectiveness of these minimally invasive procedures for ampullary tumors.
METHODS
We conducted a retrospective study of 42 patients who underwent either EP or TDA for ampullary tumors between June 2011 and November 2020.
RESULTS
We found that in patients with significantly larger tumors, TDA was often selected. Patients who underwent EP had significantly shorter hospital stays. No significant differences were observed regarding procedural accidents, tumor size, and recurrence.
CONCLUSION
No differences were observed regarding the treatment outcomes of EP and TDA except hospital stay. EP is less invasive and can be the initial choice of procedure. TDA is performed when EP is not technically feasible. No significant relationship was noted between tumor size and recurrence, and careful observation of the patient's postoperative course is required.
目的
壶腹肿瘤的标准治疗方法是胰十二指肠切除术。然而，诸如内镜下乳头切除术（EP）和经十二指肠壶腹切除术（TDA）等微创手术近来越来越受欢迎。因此，我们旨在评估这些微创手术治疗壶腹肿瘤的有效性。
方法
我们对2011年6月至2020年11月期间因壶腹肿瘤接受EP或TDA治疗的42例患者进行了一项回顾性研究。
结果
我们发现，对于肿瘤明显更大的患者，通常选择TDA。接受EP治疗的患者住院时间明显更短。在手术意外、肿瘤大小和复发方面未观察到显著差异。
结论
除住院时间外，EP和TDA的治疗结果未观察到差异。EP的侵入性较小，可以作为初始手术选择。当EP在技术上不可行时，则进行TDA。未发现肿瘤大小与复发之间存在显著关系，需要仔细观察患者的术后病程。
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