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

G. Petrone; R. Ricci; P. Familiari; F. Inzani; M. Matsuoka; M. Mutignani; G. Delle Fave; G. Costamagna; G. Rindi

doi:10.1055/s-0032-1326213

Endoscopy, Table of Contents

Endoscopy 2013; 45(05): 401-404
DOI: 10.1055/s-0032-1326213

Case report/series

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

G. Petrone^*

¹Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

R. Ricci^*

¹Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

P. Familiari

²Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

F. Inzani

¹Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

M. Matsuoka

²Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

³Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

,

M. Mutignani

²Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

G. Delle Fave

⁴Digestive and Liver Disease Department, S. Andrea Hospital, II Medical School, University “La Sapienza,” Rome, Italy

,

G. Costamagna

²Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

,

G. Rindi

¹Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

› Author Affiliations

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.

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References

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