November 12, 2014
Notes: Ketwaroo, Gyanprakash A
T32 DK007760/DK/NIDDK NIH HHS/
Gastroenterol Rep. 2013 Apr 4;1(1):27-32.
Author Address: Beth Israel Deaconess Medical Center, Department of Gastroenterology, 330 Brookline Avenue, Boston MA 02215.
Reference Type: Journal Article
Record Number: 5045Author: Kim, S. H., Moon, J. H., Choi, H. J., Kim, D. C., Lee, T. H., Cheon, Y. K., Cho, Y. D., Park, S. H. and Kim, S. J.
Title: Usefulness of pancreatic duct wire-guided endoscopic papillectomy for ampullary adenoma for preventing post-procedure pancreatitis
Short Title: Usefulness of pancreatic duct wire-guided endoscopic papillectomy for ampullary adenoma for preventing post-procedure pancreatitis
Alternate Journal: Endoscopy
ISSN: 1438-8812 (Electronic)
Accession Number: 23918619
Ampulla of Vater/radiography/*surgery
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct Neoplasms/radiography/*surgery
Pancreatitis/etiology/*prevention & control
Postoperative Complications/*prevention & control
Abstract: BACKGROUND AND STUDY AIMS: After endoscopic papillectomy, pancreatic duct stenting is important in preventing pancreatitis, but duct cannulation can be difficult following conventional snare resection. Pancreatic duct wire-guided endoscopic snaring before resection can reduce the post-procedure stenting failure rate. We evaluated the usefulness of this approach. PATIENTS AND METHODS: Pancreatic duct wire-guided endoscopic papillectomy was performed in 72 patients with ampullary adenoma. The snare loop was passed over a guide wire inserted into the pancreatic duct. After resection, a pancreatic stent was immediately placed along or alongside the guide wire. RESULTS: Pancreatic duct stenting was successful in all patients after endoscopic papillectomy. Post-procedure pancreatitis occurred in 6/72 (8 %), but was mild and resolved with conservative treatment. Complete endoscopic resection of ampullary adenoma was achieved in 65/72 (90 %), with en bloc resection in 60/72 (83 %). There was no procedure-associated mortality. Follow-up (mean 23.7 months) showed recurrence in 5/65 (8 %) who had undergone complete resection. CONCLUSIONS: Pancreatic duct wire-guided endoscopic snare papillectomy for ampullary adenoma effectively facilitated pancreatic duct stenting to prevent severe post-procedure pancreatitis.