Endoscopic papillectomy for tumors of the major duodenal papilla
Aim. To evaluate an effectiveness of endoscopic papillectomy (EA) for benign ampullary tumors. Material and methods. There were 45 patients with ampullary tumors who underwent endoscopic papillectomy in 2014-2018. Mean dimension of tumor was 2.25 ± 1.75 cm. Results. Papillectomy was successfully performed in all cases. En-bloc resection was completed in 24 cases (53%), while 21 (47%) patients had a piecemeal resection. Pancreatic duct stenting was carried out in 30 (67%) cases. Postoperative complication rate was 31%. Postoperative bleeding occurred in 8 (18%) cases, perforation in 4 (8.9%) cases, acute pancreatitis in 2 (4.4%) cases. Mortality was 4.4 % (n = 2). Local recurrence rate within 4-year period was 2.2% (n = 1). Mean length of hospital-stay was 13 days (13 ± 11) considering prolonged treatment of patients with complicated postoperative period. Conclusion. Endoscopic papillectomy is effective minimally invasive treatment of benign ampullary tumors. Regardless considerable morbidity rate, all of them may be effectively managed by medication or endoscopic procedure. EP can be considered as a first-line treatment of benign ampullary tumors.