Effectiveness of Endoscopic Papillectomy With Stent for Treating Duodenal Papillary Adenoma

Capital Medical University

Status

Completed

Conditions

Complication of Treatment

Duodenal Adenoma

Treatments

Procedure: Stent Placement in Pancreatic and Bile Ducts

Study type

Observational

Funder types

Other

Identifiers

NCT06301048

BFHHZS20230203

Details and patient eligibility

About

This is a retrospective study, including 79 patients with duodenal papillary adenoma, who treated with Endoscopic Papillectomy (EP) at Beijing friendship hospital. The cohort included patients who underwent EP with or without Pancreatic Duct (PD) and Common Bile Duct (CBD) stent placement. The investigators assessed the outcomes of EP and the impact of stent placement on complications and recurrence rates.

Full description

Duodenal papillary adenoma, a potentially malignant benign tumor is primarily treated with endoscopic papillectomy. Despite its efficacy, endoscopic papillectomy has a high complication rate. This study investigates whether pancreatic duct and common bile duct stent placement can mitigate these complications. In a retrospective analysis, 79 patients with duodenal papillary adenoma, treated with endoscopic papillectomy at our center, were studied. The cohort included patients who underwent endoscopic papillectomy with no stents placement, common bile duct stent placement alone, pancreatic duct stent placement alone, or stents placement in both ducts. Complete resection rates did not significantly differ between patients with or without stent placement. Early complication rates were similar across groups. However, significant reduction in common bile duct stenosis was observed in the stenting group. Furthermore, stent placement correlated with lower adenoma recurrence rates during follow-up. Thus, Pancreatic duct and common bile duct stent placement in endoscopic papillectomy may decrease late complications, particularly common bile duct stenosis, and reduce the recurrence of duodenal papillary adenoma.

Enrollment

79 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥18 years.
Identification of duodenal papillary lesions via gastroscopy or duodenoscopy.
Intraductal involvement <20mm.
Absence of preoperative peripheral lymph node metastasis and pancreatic/biliary duct stenosis (verified by CT, MRI, or other imaging).
Postoperative biopsy confirming adenoma.

Exclusion criteria

Diagnosis of familial adenomatous polyposis or multiple hamartoma syndrome.
Patients undergoing pancreaticoduodenectomy within a month post-EP for residual lesions.