Endoscopic papillectomy for neoplastic ampullary lesions of the Minor papilla: A systematic review

Aims Minor papillary tumors represent a rare entity encountered by endoscopists during their clinical routines. While endoscopic papillectomy (EP) is well-established for ampullary lesions (ALs) of the major duodenal papilla, its role in treating minor papilla lesions is less well-defined. This study systematically reviews the efficacy and safety of EP for minor papilla lesions to provide solid evidence on EP's effectiveness in minor papilla disease.

Methods A systematic review was conducted following PRISMA guidelines, searching various electronic databases (PubMed, Embase, and Scopus). Eighteen studies reporting on EP for minor papilla lesions were identified. Data on en-bloc resection, complete resection (R0), recurrence, adverse events, and mortality were extracted from the eligible studies.

Results A total of 49 minor papilla lesions from studies published between 1997 and 2024 were included. Patient age ranged from 21 to 84 years. En-bloc resection was achieved in 45 out of 49 lesions. Free margins were found in 43 out of 49 papillary lesions. Four recurrences were reported during the follow-up period, which ranged from 8 to 60 months; all were managed endoscopically. Adverse events occurred in 14% of cases, including 2 case of pancreatitis and 2 case of bleeding, all of which were managed successfully.

Conclusions EP appears to be a safe and effective treatment for minor papilla lesions, with high rates of complete resection and low rates of complications. However, the limited data and the predominance of case reports underscore the need for further research to validate these findings and guide clinical practice.

Publication History

Article published online:
27 March 2025