Endoscopy 2019; 51(04): S120
DOI: 10.1055/s-0039-1681523
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 14:30 – 16:00: Duodenum Club E
Georg Thieme Verlag KG Stuttgart · New York

EFFECT OF SUBMUCOSAL INJECTION IN ENDOSCOPIC PAPILLECTOMY OF AMPULLARY TUMOR: PROPENSITY-SCORE MATCHING ANALYSIS

JK Ryu
1   Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea, Republic of
,
KH Chung
1   Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea, Republic of
,
SH Lee
1   Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea, Republic of
,
YT Kim
1   Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea, Republic of
,
DH Lee
2   Seoul National University, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

The role of submucosal injection (SI) in endoscopic papillectomy (EP) is controversial. Objective:

This study investigated the effects of SI before EP of ampullary tumors.

Methods:

All patients who underwent initial curative EP at our institution between March 2006 and March 2014 were retrospectively recruited. The presence of residual tumor after three months, recurrence-free survival and post-procedural adverse events were compared between the SI group and non-injection (NI) group. Propensity-score matching was performed between the two groups to reduce potential selection bias and confounding.

Results:

A total of 122 patients were included (SI: 26, NI: 96). Following propensity-score matching, 25 paired patients were selected. Residual tumor was not shown in the NI group, whereas seven (28.0%) patients in the SI group had residual tumor (p = 0.010). The recurrence-free survival of the NI group was significantly longer than that of the SI group (p = 0.036). Upon multivariate analysis, pathologic grade (p = 0.026) and SI (p = 0.033) were significantly related to recurrence-free survival. Post-procedural adverse events were not significantly different between the two groups.

Conclusions:

SI before EP of ampullary tumor was related to more frequent residual tumor and shorter recurrence-free survival and did not reduce post-procedural adverse events.