Usefulness of pancreatic duct wire-guided endoscopic papillectomy for ampullary adenoma for preventing post-procedure pancreatitis
- Abstract
- BACKGROUND AND STUDY AIMS: After endoscopic papillectomy, pancreatic duct stenting is important in preventing pancreatitis, but duct cannulation can be difficult following conventional snare resection. Pancreatic duct wire-guided endoscopic snaring before resection can reduce the post-procedure stenting failure rate. We evaluated the usefulness of this approach. PATIENTS AND METHODS: Pancreatic duct wire-guided endoscopic papillectomy was performed in 72 patients with ampullary adenoma. The snare loop was passed over a guide wire inserted into the pancreatic duct. After resection, a pancreatic stent was immediately placed along or alongside the guide wire. RESULTS: Pancreatic duct stenting was successful in all patients after endoscopic papillectomy. Post-procedure pancreatitis occurred in 6/72 (8 %), but was mild and resolved with conservative treatment. Complete endoscopic resection of ampullary adenoma was achieved in 65/72 (90 %), with en bloc resection in 60/72 (83 %). There was no procedure-associated mortality. Follow-up (mean 23.7 months) showed recurrence in 5/65 (8 %) who had undergone complete resection. CONCLUSIONS: Pancreatic duct wire-guided endoscopic snare papillectomy for ampullary adenoma effectively facilitated pancreatic duct stenting to prevent severe post-procedure pancreatitis.
- All Author(s)
- S. H. Kim
; J. H. Moon
; H. J. Choi
; D. C. Kim
; T. H. Lee
; Y. K. Cheon
; Y. D. Cho
; S. H. Park
; S. J. Kim
- Issued Date
- 2013
- Type
- Article
- Publisher
- Georg Thieme Verlag
- ISSN
- 0013-726X
; 1438-8812
- Citation Title
- Endoscopy
- Citation Volume
- 45
- Citation Number
- 10
- Citation Start Page
- 838
- Citation End Page
- 841
- Language(ISO)
- eng
- DOI
- 10.1055/s-0033-1344392
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/879
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