Nguyen Minh Thu T, Paladiya Ruchir, Dahiya Dushyant Singh, Dharan Murali
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA.
Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA.
J Clin Med. 2025 May 18;14(10):3532. doi: 10.3390/jcm14103532.
Ampullary adenomas are rare outgrowths at the ampulla of Vater that may progress into cancer via the adenoma-to-carcinoma sequence, particularly in individuals with hereditary polyposis syndrome. Many are diagnosed incidentally or once the lesion becomes large enough to cause obstruction. Traditionally managed surgically with high morbidity and mortality, advances in imaging and therapy have made endoscopic ampullectomy the first-line treatment for noninvasive lesions. Despite its high success rate and favorable safety profile, complications such as pancreatitis, ductal stenosis, bleeding, recurrence, and perforation can occur. Recommendations for optimal endoscopic techniques and surveillance intervals are largely based on expert opinion in interventional endoscopy and findings from small-scale studies. This review provides an updated framework for the diagnosis and management of ampullary adenomas.
壶腹腺瘤是发生在十二指肠乳头的罕见赘生物，可通过腺瘤-癌序列发展为癌症，尤其是在患有遗传性息肉病综合征的个体中。许多病例是在偶然情况下被诊断出来的，或者是在病变足够大以致引起梗阻时才被发现。传统上通过手术治疗，其发病率和死亡率较高，而影像学和治疗方法的进步使内镜下壶腹切除术成为非侵袭性病变的一线治疗方法。尽管其成功率高且安全性良好，但仍可能发生胰腺炎、导管狭窄、出血、复发和穿孔等并发症。关于最佳内镜技术和监测间隔的建议主要基于介入性内镜领域的专家意见以及小规模研究的结果。本综述为壶腹腺瘤的诊断和管理提供了一个更新的框架。
