Endoscopic papillectomy for laterally spreading lesions of the papilla: a propensity score-matched analysis
Endoscopic papillectomy is a standard treatment for ampullary lesions, which are typically small and confined to the papillary mound. Laterally spreading lesions (LSLs) of the papilla of Vater are a rare ampullary lesion subtype involving extensive duodenal mucosa. Data on endoscopic papillectomy ou...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2025
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| In: |
Endoscopy
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| ISSN: | 1438-8812 |
| DOI: | 10.1055/a-2641-0614 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1055/a-2641-0614 Verlag, lizenzpflichtig, Volltext: http://www.thieme-connect.de.ezproxy.medma.uni-heidelberg.de/DOI/DOI?10.1055/a-2641-0614 
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| Verfasserangaben: | Authors: Kien Vu Trung, Einas Abou-Ali, Aiste Gulla, Kevin Soares, Fabrice Caillol, Woo H. Paik, Bertrand Napoleon, Asif Halimi, Viliam Masaryk, Marco J. Bruno, Enrique Pérez-Cuadrado-Robles, Louisa Bolm, Steffen Seyfried, Maria C. Petrone, Bengisu Yilmaz, Charles Vollmer, Arthur Berger, Laura Maggino, Peter Schemmer, Dörte Wichmann, Elias Karam, Ana Dugic, Sara Regnér, Sebastien Gaujoux, Marcus Hollenbach |
MARC
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| 245 | 1 | 0 | |a Endoscopic papillectomy for laterally spreading lesions of the papilla |b a propensity score-matched analysis |c Authors: Kien Vu Trung, Einas Abou-Ali, Aiste Gulla, Kevin Soares, Fabrice Caillol, Woo H. Paik, Bertrand Napoleon, Asif Halimi, Viliam Masaryk, Marco J. Bruno, Enrique Pérez-Cuadrado-Robles, Louisa Bolm, Steffen Seyfried, Maria C. Petrone, Bengisu Yilmaz, Charles Vollmer, Arthur Berger, Laura Maggino, Peter Schemmer, Dörte Wichmann, Elias Karam, Ana Dugic, Sara Regnér, Sebastien Gaujoux, Marcus Hollenbach |
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| 520 | |a Endoscopic papillectomy is a standard treatment for ampullary lesions, which are typically small and confined to the papillary mound. Laterally spreading lesions (LSLs) of the papilla of Vater are a rare ampullary lesion subtype involving extensive duodenal mucosa. Data on endoscopic papillectomy outcomes for LSLs are limited. This study compared endoscopic papillectomy for ampullary LSLs and non-LSLs in matched cohorts. The ESAP study (Endoscopic papillectomy vs. Surgical Ampullectomy vs. Pancreaticoduodenectomy for ampullary neoplasm) encompassed 1422 endoscopic papillectomies. Propensity score matching used the nearest-neighbor method for age, sex, co-morbidity, and histologic subtype as cofactors. The main outcomes were complete resection (R0), technical success, complications, and recurrences. Propensity score-based matching identified 232 patients with ampullary lesions (116 non-LSL, 116 LSL) with comparable baseline characteristics. After first intervention, the R0 resection rate, the primary outcome measure, was significantly lower in the LSL group (54.3% [95%CI 45.3%-63.1%]) vs. 69.0% [95%CI 60.4%-76.6%]). Following repeated endoscopic interventions, technical success was similar in both groups (82.8%). After a 22-month median follow-up, the LSL group had significantly more recurrences (41.3% vs. 15.0%) and lower 1- and 3-year disease-free survival rates (61.1% and 44.0% vs. 86.1% and 81.6%, respectively). Complication rates did not differ significantly between the two groups (LSL 32.8% vs. non-LSL 26.7%). LSLs can be safely resected by endoscopic papillectomy, although repeated interventions are necessary to achieve complete resection. The higher risk of recurrence in LSLs necessitates a vigilant surveillance strategy. | ||
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| 700 | 1 | |a Yilmaz, Bengisu |e VerfasserIn |4 aut | |
| 700 | 1 | |a Vollmer, Charles |e VerfasserIn |4 aut | |
| 700 | 1 | |a Berger, Arthur |e VerfasserIn |4 aut | |
| 700 | 1 | |a Maggino, Laura |e VerfasserIn |4 aut | |
| 700 | 1 | |a Schemmer, Peter |e VerfasserIn |4 aut | |
| 700 | 1 | |a Wichmann, Dörte |e VerfasserIn |4 aut | |
| 700 | 1 | |a Karam, Elias |e VerfasserIn |4 aut | |
| 700 | 1 | |a Dugic, Ana |e VerfasserIn |4 aut | |
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