Endoscopy 2013; 45(05): 401-404
DOI: 10.1055/s-0032-1326213
Case report/series
© Georg Thieme Verlag KG Stuttgart · New York

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

G. Petrone*
1   Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
R. Ricci*
1   Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
P. Familiari
2   Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
F. Inzani
1   Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
M. Matsuoka
2   Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
3   Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
,
M. Mutignani
2   Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
G. Delle Fave
4   Digestive and Liver Disease Department, S. Andrea Hospital, II Medical School, University “La Sapienza,” Rome, Italy
,
G. Costamagna
2   Digestive Endoscopy Unit, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
G. Rindi
1   Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
› Author Affiliations
Further Information

Publication History

submitted 08 May 2012

accepted after revision 04 December 2012

Publication Date:
24 April 2013 (online)

Preview

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.

* Both authors contributed equally to this work.