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01-02-2021 | Familial Adenomatous Polyposis | Original Article

Endoscopic Papillectomy for Ampullary Adenomas: Different Outcomes in Sporadic Tumors and Those Associated with Familial Adenomatous Polyposis

Authors: Paolo Cecinato, Francesca Parmeggiani, Luca Braglia, Gabriele Carlinfante, Ramona Zecchini, Francesco Decembrino, Veronica Iori, Giuliana Sereni, Cristiana Tioli, Maurizio Cavina, Lorenzo Camellini, Francesco Azzolini, Maurizio Ponz de Leon, Romano Sassatelli

Published in: Journal of Gastrointestinal Surgery | Issue 2/2021

Abstract

Background

Ampullary adenomas are rare and potentially malignant. Surgery was the standard treatment but endoscopic papillectomy (EP) is a possible alternative.

Aim

We retrospectively evaluated the principal clinical outcomes of EP in all patients referred to our unit also dividing sporadic ampullary adenoma (SAA) from familial adenomatous polyposis (FAP)–associated adenomas.

Methods

All consecutive patients who underwent endoscopic papillectomy because of ampullary adenoma were considered. The primary outcome was the technical success of EP. Secondary outcomes included the number of procedures, the adverse event rate, the recurrence rate, the concordance of histology pre- and post-EP, and the evaluation of factors related to technical success.

Results

Between January 2001 and December 2015, sixty-two patients were included (21 FAP and 41 SAA). Technical success was achieved in 75.8% and was different in the two groups (FAP 95.2%, SAA 65.8%, p 0.025). Intraductal invasion was negatively associated with technical success (41.7% vs. 84.0%; p 0.005). The intestinal subtype was predictive of success (79.7% vs. 0%; p 0.012) as well as en bloc resection (90.3% vs. 61.3%; p 0.016). Adverse events were reported in 14 patients (22.6%).

Conclusions

EP is an effective and safe procedure and is a viable alternative to surgery.

Trial Registration

ClinicalTrials.gov Identifier: NCT03494543

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Title: Endoscopic Papillectomy for Ampullary Adenomas: Different Outcomes in Sporadic Tumors and Those Associated with Familial Adenomatous Polyposis
Authors: Paolo Cecinato
Francesca Parmeggiani
Luca Braglia
Gabriele Carlinfante
Ramona Zecchini
Francesco Decembrino
Veronica Iori
Giuliana Sereni
Cristiana Tioli
Maurizio Cavina
Lorenzo Camellini
Francesco Azzolini
Maurizio Ponz de Leon
Romano Sassatelli
Publication date: 01-02-2021
Publisher: Springer US
Keyword: Familial Adenomatous Polyposis
Published in: Journal of Gastrointestinal Surgery / Issue 2/2021
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04500-w

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Springer Medicine

Endoscopic Papillectomy for Ampullary Adenomas: Different Outcomes in Sporadic Tumors and Those Associated with Familial Adenomatous Polyposis

Abstract

Background

Aim

Methods

Results

Conclusions

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusions

Trial Registration

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