Usefulness of argon plasma coagulation ablation subsequent to endoscopic snare papillectomy for ampullary adenoma.
Dig Endosc
; 30(4): 485-492, 2018 Jul.
Article
in En
| MEDLINE
| ID: mdl-29288506
ABSTRACT
BACKGROUND AND AIM:
Endoscopic snare papillectomy (ESP) is an effective treatment for ampullary adenoma. Argon plasma coagulation (APC) is widely used as an additional method to control bleeding or ablate the residual tumor. However, the efficacy of this procedure has not yet been fully evaluated. This study aimed to evaluate the usefulness of APC as an additional method to ESP.METHODS:
Patients who underwent ESP for ampullary adenoma between September 2005 and September 2015 were retrospectively reviewed. Using propensity score matching, we compared short- and long-term outcomes between the ESP-with-additional-APC group (ESP + APC group) and the ESP-only group. Primary outcome was early post-ESP adverse events (AE), and secondary outcomes were late AE and recurrence.RESULTS:
Among 109 patients, additional APC was carried out in 59 (54.1%) patients. After matching, 41 patients were included in both groups, respectively. Bleeding rate was significantly lower in the ESP + APC group than in the ESP-only group (7.3% vs 31.7%, odds ratio = 0.180, P < 0.01). However, there were no significant differences in other procedure-related early AE such as pancreatitis (12.2% vs 19.5%, P = 0.365), cholangitis (2.4% vs 9.8%, P = 0.198), and perforation (2.4% vs 2.4%, P = 1.000) between the ESP + APC group and the ESP-only group. During the follow-up period (mean 904 ± 868 days), papillary stricture (9.8% vs 4.9%, P = 0.405) and recurrence rates (24.4% vs 24.4%, P = 0.797) were not significantly different between the ESP + APC group and the ESP-only group.CONCLUSION:
Additional APC during ESP may have a beneficial effect by decreasing bleeding rate without harmful effects.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ampulla of Vater
/
Adenoma
/
Blood Loss, Surgical
/
Common Bile Duct Neoplasms
/
Argon Plasma Coagulation
/
Endoscopic Mucosal Resection
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Dig Endosc
Journal subject:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Year:
2018
Type:
Article
Affiliation country:
South Korea