Endoscopic papillectomy versus surgical ampullectomy for adenomas and early cancers of the papilla: a retrospective Pancreas2000/European Pancreatic Club analysis
Hollenbach, M. ; Regnér, S. LU
and Gaujoux, S.
(2024)
In Gut
74(3).
p.397-409
- Abstract
- Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA. Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded. All remaining cases as well as a subgroup of them, after propensity-score matching (nearest-neighbour-method) based on age, gender, anthropometrics, comorbidities, size and histological subtype, were analysed. The median follow-up was 21 months (IQR... (More)
- Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA. Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded. All remaining cases as well as a subgroup of them, after propensity-score matching (nearest-neighbour-method) based on age, gender, anthropometrics, comorbidities, size and histological subtype, were analysed. The median follow-up was 21 months (IQR 10-47) after the primary intervention. Primary outcomes were rates of complete resection (R0) and complications. Groups were compared by Fisher's exact or χ2 test, Mann-Whitney-U-test and log-rank test for survival. Results: Of 1673 patients in the database, 1422 underwent EP and 251 TSA. Of them, 23.2% were excluded for missing or inconclusive data and 19.8% of patients for prior interventions or hereditary syndromes. Final histology showed in 24.2% of EP and 14.8% of TSA patients a histology other than adenoma or adenocarcinoma while advanced cancers were recorded in 10.9% of EP and 36.6% of TSA patients. Finally, 569 EP and 63 TSA were included in the overall analysis, with a higher rate of more advanced cases and higher R0 resection rates in the TSA groups (90.5% vs 73.1%; p (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/cf9ba656-ae30-44dc-a375-b83be27be6b3
- author
- Hollenbach, M.
; Regnér, S.
LU
and Gaujoux, S.
- author collaboration
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ENDOSCOPIC PROCEDURES, ENDOSCOPIC RETROGRADE PANCREATOGRAPHY, PANCREATIC CANCER, PANCREATIC TUMOURS, PANCREATICODUODENECTOMY
- in
- Gut
- volume
- 74
- issue
- 3
- pages
- 13 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85213841232
- pmid:39642968
- ISSN
- 0017-5749
- DOI
- 10.1136/gutjnl-2022-327996
- language
- English
- LU publication?
- yes
- id
- cf9ba656-ae30-44dc-a375-b83be27be6b3
- date added to LUP
- 2025-12-16 13:52:32
- date last changed
- 2025-12-17 03:00:03
@article{cf9ba656-ae30-44dc-a375-b83be27be6b3,
abstract = {{Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA. Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded. All remaining cases as well as a subgroup of them, after propensity-score matching (nearest-neighbour-method) based on age, gender, anthropometrics, comorbidities, size and histological subtype, were analysed. The median follow-up was 21 months (IQR 10-47) after the primary intervention. Primary outcomes were rates of complete resection (R0) and complications. Groups were compared by Fisher's exact or χ2 test, Mann-Whitney-U-test and log-rank test for survival. Results: Of 1673 patients in the database, 1422 underwent EP and 251 TSA. Of them, 23.2% were excluded for missing or inconclusive data and 19.8% of patients for prior interventions or hereditary syndromes. Final histology showed in 24.2% of EP and 14.8% of TSA patients a histology other than adenoma or adenocarcinoma while advanced cancers were recorded in 10.9% of EP and 36.6% of TSA patients. Finally, 569 EP and 63 TSA were included in the overall analysis, with a higher rate of more advanced cases and higher R0 resection rates in the TSA groups (90.5% vs 73.1%; p}},
author = {{Hollenbach, M. and Regnér, S. and Gaujoux, S.}},
issn = {{0017-5749}},
keywords = {{ENDOSCOPIC PROCEDURES; ENDOSCOPIC RETROGRADE PANCREATOGRAPHY; PANCREATIC CANCER; PANCREATIC TUMOURS; PANCREATICODUODENECTOMY}},
language = {{eng}},
number = {{3}},
pages = {{397--409}},
publisher = {{BMJ Publishing Group}},
series = {{Gut}},
title = {{Endoscopic papillectomy versus surgical ampullectomy for adenomas and early cancers of the papilla: a retrospective Pancreas2000/European Pancreatic Club analysis}},
url = {{http://dx.doi.org/10.1136/gutjnl-2022-327996}},
doi = {{10.1136/gutjnl-2022-327996}},
volume = {{74}},
year = {{2024}},
}