Retrospective Analysis Of Endoscopic Resection Of Duodenal Papilla Adenoma

Objective: To discuss the safety and effectiveness of the endoscopic resection of duodenal papillectomy(EP).Methods: Clinical data of 10 patients,including 8 males and2 females,who underwent endoscopic duodenal papilladenoma resection from the Digestive Endoscopy Center of the General Hospital of Xinjiang Military Region from June 2019 to September 2022 were retrospectively analyzed,and their demographic characteristics,clinical manifestations,endoscopic manifestations,complications,pathological characteristics and follow-up were summarized.Results: A total of 10 patients were included in this study according to the inclusion and exclusion criteria,including 2 females(20%)and 8 males(80%).Patients ranged in age from 54 to 73 years,with an average age of 62.There were 3 cases(30%)complicated with dyspepsia on admission,and 4 cases(40%)were found by physical examination.Asymptomatic bile duct dilatation in 2 cases(20%);Intraductal extension in 1 case(10%);Lesions were confined to the ampulla in 9 patients(90%);One case was intraductal extension adenoma(10%).The average lesion size was 20.4mm(8-30.3 mm).Eight lesions(80%)were excised en masse and two lesions(20%)were excised en masse.Biliary pancreatic duct stent was implanted in 6 cases(60%).9 cases were completely resected and 1 case had positive residual margin.The success rate was 90%.Complication rate 40%(4/10): 3cases(30%)bleeding;3 cases(30%)had mild acute pancreatitis;1 case(10%)perforated;Relapse occurred in 3 cases(30%).There were 2 cases of tubular adenoma(20%),3 cases of high-grade intraepithelial neoplasia(30%),3 cases of villous adenoma(30%),1 case of low-grade intraepithelial neoplasia(10%),and 1 case of adenocarcinoma,with positive incisal margin(10%)and a completely negative incisal margin rate of 90%.Conclusions:Endoscopic resection of duodenal papilloma is a high-risk and effective minimally invasive treatment.Pancreatic duct stent placement can reduce the incidence of pancreatitis.Postoperative endoscopic follow-up should be conducted closely to timely deal with recurrence and residual...