Year 2016 / Volume 108 / Number 5
Review
Endoscopic ampullectomy: a technical review

271-278

DOI: 10.17235/reed.2016.3867/2015

Jesús Espinel, Eugenia Pinedo, Vanesa Ojeda, María Guerra del Río,

Abstract
Background and aim: This article provides a practical review to undertaking safe endoscopic ampullectomy and highlights some of the common difficulties with this technique as well as offering strategies to deal with these challenges. Methods: We conducted a review of studies regarding endoscopic ampullectomy for ampullary neoplasms with special focus on techniques. Results: Accurate preoperative diagnosis and staging of ampullary tumors is imperative for predicting prognosis and determining the most appropriate therapeutic approach. The optimal technique for endoscopic ampullectomy is dependent on the lesions size. En bloc resection is recommended for lesions confined to the papilla. There is no significant evidence to support the submucosal injection before ampullectomy. There is no consensus regarding the optimal current and power output for endoscopic ampulectomy. The benefits of a thermal adjunctive therapy remain controversial. A prophylactic pancreatic stent reduces the incidence and severity of pancreatitis post-ampullectomy. Conclusions: Endoscopic ampullectomy is a safe and efficacious therapeutic procedure for papillary adenomas in experienced endoscopist and it can avoid the need for surgical intervention.
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Espinel J, Pinedo E, Ojeda V, Guerra del Río M. Endoscopic ampullectomy: a technical review. 3867/2015


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Publication history

Received: 27/05/2015

Accepted: 08/10/2015

Online First: 10/12/2015

Published: 29/04/2016

Article revision time: 128 days

Article Online First time: 197 days

Article editing time: 338 days


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