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Ampullary adenoma

Frank G J Kallenberg, Barbara A J Bastiaansen, Evelien Dekker
Background and study aims: Guidelines recommend surveillance endoscopy with both forward- and side-viewing endoscopes to identify duodenal and ampullary adenomas in patients with familial adenomatous polyposis (FAP). We hypothesized that both the duodenum and the ampulla of Vater can be completely visualized during cap-assisted forward-viewing endoscopy. Patients and methods: A total of 40 patients with FAP underwent forward-viewing endoscopy with a short cap attached to the tip of the gastroscope, with the aim of visualizing both the duodenum and the ampulla of Vater...
October 19, 2016: Endoscopy
Yue Xue, Alessandro Vanoli, Serdar Balci, Michelle M Reid, Burcu Saka, Pelin Bagci, Bahar Memis, Hyejeong Choi, Nobuyike Ohike, Takuma Tajiri, Takashi Muraki, Brian Quigley, Bassel F El-Rayes, Walid Shaib, David Kooby, Juan Sarmiento, Shishir K Maithel, Jessica H Knight, Michael Goodman, Alyssa M Krasinskas, Volkan Adsay
Literature on non-ampullary-duodenal carcinomas is limited. We analyzed 47 resected non-ampullary-duodenal carcinomas. Histologically, 78% were tubular-type adenocarcinomas mostly gastro-pancreatobiliary type and only 19% pure intestinal. Immunohistochemistry (n=38) revealed commonness of 'gastro-pancreatobiliary markers' (CK7 55, MUC1 50, MUC5AC 50, and MUC6 34%), whereas 'intestinal markers' were relatively less common (MUC2 36, CK20 42, and CDX2 44%). Squamous and mucinous differentiation were rare (in five each); previously, unrecognized adenocarcinoma patterns were noted (three microcystic/vacuolated, two cribriform, one of comedo-like, oncocytic papillary, and goblet-cell-carcinoid-like)...
October 14, 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Jong Jin Hyun, Tae Hoon Lee, Jin-Seok Park, Joung-Ho Han, Seok Jeong, Seon Mee Park, Hong Sik Lee, Jong Ho Moon, Sang-Heum Park
BACKGROUND AND AIMS: Whether or not submucosal injection of a diluted epinephrine solution should be used to lift ampullary tumors during endoscopic snare papillectomy is unclear. This study aimed to investigate the clinical efficacy of a simple snaring method versus submucosal injection for papillectomy. METHODS: A prospective multicenter study was performed at 4 tertiary referral centers. Patients with papillary lesions were randomized to undergo either simple snare papillectomy (SSP) or submucosal injection papillectomy (SIP) using 1:10,000 diluted epinephrine...
August 24, 2016: Gastrointestinal Endoscopy
Alejandro L Suarez, Gregory A Coté, B Joseph Elmunzer
Catheter-based radiofrequency ablation (RFA) delivered during endoscopic retrograde cholangiopancreatography (ERCP) may represent a viable treatment option for intraductal extension of ampullary neoplasms, however, clinical experience with this modality is limited. After ampullary resection, 4 patients with intraductal extension underwent adjunctive RFA of the distal bile duct. All patients received a temporary pancreatic stent to reduce the risk of pancreatitis, as well as a plastic biliary stent to prevent biliary obstruction...
July 2016: Endoscopy International Open
Lisa S Cassani, Gandhi Lanke, Hsiang-Chun Chen, Xuemei Wang, Patrick Lynch, Jeffrey H Lee
BACKGROUND AND AIMS: Nonampullary duodenal adenomas are either sporadic or associated with a hereditary syndrome such as familial adenomatous polyposis (FAP). The aim of this study is to compare characteristics and outcomes of sporadic and FAP-associated duodenal adenomas. METHODS: We retrospectively collected clinical, endoscopic, and pathologic data in patients diagnosed with duodenal adenomas at our institution and included all available follow-up. RESULTS: Two hundred thirteen subjects were identified; 118 had FAP and 95 had sporadic adenomas...
August 13, 2016: Gastrointestinal Endoscopy
Jesús Espinel, Eugenia Pinedo, Vanesa Ojeda, María Guerra Del Río
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...
May 2016: Revista Española de Enfermedades Digestivas
Seoung Ho Lee, Tae Hoon Lee, Si-Hyong Jang, Chi Young Choi, Won Myung Lee, Ji Hey Min, Hyun Deuk Cho, Sang-Heum Park
Ampullary adenoma is a common indication for endoscopic papillectomy. Ampullary neuroendocrine tumor (NET) is a rare disease for which complete surgical resection is the treatment of choice. However, because of the morbidity and mortality associated with surgical resection, endoscopic papillectomy is increasingly used in selected cases of low grade, with no metastasis and no invasion of the pancreatic or bile duct. Also, confirmed and complete endoscopic resection of ampullary NET accompanied by adenoma has not been reported to date...
April 7, 2016: World Journal of Gastroenterology: WJG
Ernesto Quaresma Mendonça, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura, Dalton Marques Chaves, André Kondo, Leonardo Zorrón Cheng Tao Pu, Felipe Iankelevich Baracat
The aim of this study is to address the outcomes of endoscopic resection compared with surgery in the treatment of ampullary adenomas. A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For this purpose, the Medline, Embase, Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were scanned...
January 2016: Clinics
Jonathan P Gaspar, Edward B Stelow, Andrew Y Wang
Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection...
January 14, 2016: World Journal of Gastroenterology: WJG
Yoon Jeong Nam, Si Hyung Lee, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Yong Jin Kim
BACKGROUND/AIMS: Sporadic non-ampullary duodenal neoplasms are rare and optimal treatment for these lesions remains undefined. Endoscopic resection of duodenal neoplasms is widely used recently and it is an alternative treatment strategy to surgical excision. This study aimed to evaluate the safety and efficacy of endoscopic resection of duodenal neoplasms and to determine its outcomes. METHODS: Patients who underwent endoscopic resection for non-ampullary duodenal neoplasms between January 2005 and December 2014 were analyzed retrospectively...
January 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Lutz Schneider, Pietro Contin, Stefan Fritz, Oliver Strobel, Markus W Büchler, Thilo Hackert
INTRODUCTION: Benign neoplastic, inflammatory or functional pathologies of the ampulla of Vater are mainly treated by primary endoscopic interventions. Consequently, transduodenal surgical ampullectomy (TSA) has been abandoned in many centres, although it represents an important tool not only after unsuccessful endoscopic treatment. The aim of the study was to analyse TSA for benign lesions of the ampulla of Vater. PATIENTS AND METHODS: All patients who underwent TSA between 2001 and 2014 were included...
January 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Shigetsugu Tsuji, Hisashi Doyama, Kunihiro Tsuji, Sho Tsuyama, Kei Tominaga, Naohiro Yoshida, Kenichi Takemura, Shinya Yamada, Hideki Niwa, Kazuyoshi Katayanagi, Hiroshi Kurumaya, Toshihide Okada
Superficial non-ampullary duodenal epithelial tumor (SNADET) is defined as a sporadic tumor that is confined to the mucosa or submucosa that does not arise from Vater's papilla, and it includes adenoma and adenocarcinoma. Recent developments in endoscopic technology, such as high-resolution endoscopy and image-enhanced endoscopy, may increase the chances of detecting SNADET lesions. However, because SNADET is rare, little is known about its preoperative endoscopic diagnosis. The use of endoscopic resection for SNADET, which has no risk of metastasis, is increasing, but the incidence of complications, such as perforation, is significantly higher than in any other part of the digestive tract...
November 7, 2015: World Journal of Gastroenterology: WJG
Roberto Valente, Ondrej Urban, Marco Del Chiaro, Gabriele Capurso, John Blomberg, J Matthias Löhr, Urban Arnelo
No abstract text is available yet for this article.
2015: Endoscopy
Jesús Espinel, Eugenia Pinedo, Vanesa Ojeda, Maria Guerra Del Rio
Lesions of the ampulla of Vater represent an uncommon group of gastrointestinal malignancies. The majority of lesions of the ampulla of Vater are either adenomas or adenocarcinomas. Ampullary lesions are often incidental findings. Accurate preoperative diagnosis and staging of ampullary tumors is imperative for predicting prognosis and determining the most appropriate therapeutic approach. Endoscopic ampullectomy is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention...
September 26, 2015: World Journal of Methodology
Yuji Iwashita, Kei Ito, Yutaka Noda, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yosuke Michikawa
BACKGROUND: Although ampullary adenomas have been reported to be considered as precancerous lesions, there have been very few reports of cases in which cancer occurred after long-term follow-up. We herein report a case of ampullary adenoma that developed to cancer after long-term observation. CASE REPORT: An 81-year-old man was referred to our hospital due to a tumor at the ampulla of Vater. Histological examination revealed a tubular adenoma. Because the patient refused treatment, follow-up by duodenoscopy, EUS, MRCP, and forceps biopsy was planned...
2015: American Journal of Case Reports
José Celso Ardengh, Rafael Kemp, Éder Rios Lima-Filho, José Sebastião Dos Santos
In the majority of cases, duodenal papillary tumors are adenomas or adenocarcinomas, but the endoscopy biopsy shows low accuracy to make the correct differentiation. Endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography are important tools for the diagnosis, staging and management of ampullary lesions. Although the endoscopic papillectomy (EP) represent higher risk endoscopic interventions, it has successfully replaced surgical treatment for benign or malignant papillary tumors. The authors review the epidemiology and discuss the current evidence for the use of endoscopic procedures for resection, the selection of the patient and the preventive maneuvers that can minimize the probability of persistent or recurrent lesions and to avoid complications after the procedure...
August 10, 2015: World Journal of Gastrointestinal Endoscopy
Krishnavel V Chathadi, Mouen A Khashab, Ruben D Acosta, Vinay Chandrasekhara, Mohamad A Eloubeidi, Ashley L Faulx, Lisa Fonkalsrud, Jenifer R Lightdale, John R Salztman, Aasma Shaukat, Amy Wang, Brooks D Cash, John M DeWitt
No abstract text is available yet for this article.
November 2015: Gastrointestinal Endoscopy
Yoshiaki Isono, Shimpei Matsusaki, Youichirou Baba, Hiroki Tanaka, Tomohiro Sase, Tomonori Saito, Hiroshi Okano, Hiroki Taoka, Gen Watanabe, Katsumi Mukai
A 70-year-old woman with jaundice was referred to our hospital. Obstructive jaundice caused by common bile duct (CBD) stones was diagnosed based on the results of blood tests, abdominal computed tomography, and endoscopic retrograde cholangiopancreatography. We attempted to remove the CBD stones endoscopically. After endoscopic sphincterotomy, a polypoid lesion was exposed at the ampulla of Vater. Histological examination of a biopsy specimen from the ampullary lesion revealed a tubular adenoma, and the patient underwent pylorus-preserving pancreatoduodenectomy...
August 2015: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Hiromitsu Soma, Naoteru Miyata, Shigenari Hozawa, Hajime Higuchi, Yoshiyuki Yamagishi, Yuji Nakamura, Keita Saeki, Kaori Kameyama, Yohei Masugi, Naohisa Yahagi, Takanori Kanai
We report herein improved methods for the safe and successful completion of endoscopic papillectomy (EP). Between January 2008 and November 2011, 12 patients underwent double-snare retracting papillectomy for the treatment of lesions of the major duodenal papilla. The main outcomes were en bloc resection rates, pathological findings, and adverse events. All of the patients (mean age, 60.1 years; range, 38 to 80 years) were diagnosed with ampullary adenoma by endoscopic forceps biopsies prior to endoscopic snare papillectomy...
September 23, 2015: Gut and Liver
Hee Seung Lee, Jong Soon Jang, Seungho Lee, Myeong Ho Yeon, Ki Bae Kim, Jae Geun Park, Joo Young Lee, Mi Jin Kim, Joung-Ho Han, Rohyun Sung, Seon Mee Park
BACKGROUND/AIMS: Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis. METHODS: We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy. RESULTS: Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor...
May 2015: Clinical Endoscopy
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