Affiliation:
1. Department of Gastroenterology and Hepatology Yokohama City University School of Medicine Yokohama Japan
2. Department of Oncology Yokohama City University School of Medicine Yokohama Japan
3. Department of Gastroenterological Surgery Yokohama City University School of Medicine Yokohama Japan
4. Department of Hepato‐Biliary‐Pancreatic Medicine NTT Medical Center Tokyo Tokyo Japan
5. Department of Pathology Yokohama City University School of Medicine Yokohama Japan
Abstract
AbstractBackground/PurposeThere is currently no consensus on the use of endoscopic papillectomy (EP) for early stage duodenal ampullary adenocarcinoma. This study aimed to evaluate the feasibility of EP for patients with early stage duodenal ampullary adenocarcinoma.MethodsPatients who underwent EP for ampullary adenocarcinomas were investigated. Complete and clinical complete resection rates were evaluated. Clinical complete resection was defined as either complete resection or resection with positive or unknown margins but no cancer in the surgically resected specimen, or no recurrence on endoscopy after at least a 1‐year follow‐up.ResultsAdenocarcinoma developed in 30 patients (carcinoma in situ [Tis]: 21, mucosal tumors [T1a(M)]: 4, tumors in the sphincter of Oddi [T1a(OD)]: 5). The complete resection rate was 60.0% (18/30) (Tis: 66.7% [14/21], T1a[M]: 50.0% [2/4], and T1a[OD]: 40.0% [2/5]). The mean follow‐up period was 46.8 months. The recurrence rate for all patients was 6.7% (2/30). The clinical complete resection rates of adenocarcinoma were 89.2% (25/28); rates for Tis, T1a(M), and T1a(OD) were 89.4% (17/19), 100% (4/4), and 80% (4/5), respectively.ConclusionsEP may potentially achieve clinical complete resection of early stage (Tis and T1a) duodenal ampullary adenocarcinomas.