Success and complications of endoscopic removal of giant duodenal and ampullary polyps: a comparative series.
Gastrointest Endosc
; 64(6): 925-32, 2006 Dec.
Article
em En
| MEDLINE
| ID: mdl-17140900
ABSTRACT
BACKGROUND:
Increasing reports suggest that endoscopic removal of benign ampullary and duodenal polyps is safe and frequently definitive; however, most reported polyps have been small in size (<3 cm). We have developed experience with endoscopic removal of increasingly large and complex polyps. PATIENTS Fifty-one cases of endoscopic removal were attempted and grouped according to size group A (n = 22) polyps 1 to 3 cm and group B (n = 29) polyps 3 cm or larger, including 7 cases larger than 5 cm. When the ampulla was involved, biductal sphincterotomy and prophylactic pancreatic duct stent placement was performed first, followed by saline solution-assisted piecemeal polypectomy, argon plasma coagulation, selective endoclip placement, and recovery of all polyp fragments.INTERVENTIONS:
Endoscopic removal of duodenal and ampullary adenomas.RESULTS:
The outcomes of small and large adenoma removal include mean number of endoscopic retrograde cholangiopancreatographies required for complete removal (2.09 vs 2.56, P = .392), number of complications (4.5% vs 13.9%, P = .375), discovery of unsuspected cancer (0% vs 10.3%, P = .242), and final definitive resolution (100% vs 86.2%, P = .124). Complete removal was achieved in 92.2% of all patients.LIMITATIONS:
This was a single center retrospective study.CONCLUSIONS:
Large (>/=3 cm) ampullary and duodenal polyps comprised 56.9% of our endoscopically treated cases and present special challenges to definitive endoscopic removal. Successful removal of even very large sessile lesions is possible with minimal increase in risk.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pólipos
/
Ampola Hepatopancreática
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Endoscopia do Sistema Digestório
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Neoplasias do Ducto Colédoco
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Neoplasias Duodenais
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
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Aged80
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article