J 2021

Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

VANBIERVLIET, G., M. STRIJKER, M. ARVANITAKIS, A. AELVOET, U. ARNELO et. al.

Basic information

Original name

Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Authors

VANBIERVLIET, G. (guarantor), M. STRIJKER, M. ARVANITAKIS, A. AELVOET, U. ARNELO, T. BEYNA, O. BUSCH, P. H. DEPREZ, Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), A. LARGHI, G. MANES, A. MOSS, B. NAPOLEON, M. NAYAR, E. PEREZ-CUADRADO-ROBLES, S. SEEWALD, M. BARTHET and J. E. VAN HOOFT

Edition

Endoscopy, STUTTGART, GEORG THIEME VERLAG KG, 2021, 0013-726X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 9.776

RIV identification code

RIV/00216224:14110/21:00121429

Organization unit

Faculty of Medicine

UT WoS

000629334400001

Keywords in English

ampullary tumors; endoscopic management

Tags

International impact, Reviewed
Změněno: 17/5/2022 09:00, Mgr. Tereza Miškechová

Abstract

V originále

Main Recommendations 1 ESGE recommends against diagnostic/therapeutic papillectomy when adenoma is not proven. Strong recommendation, low quality evidence. 2 ESGE recommends endoscopic ultrasound and abdominal magnetic resonance cholangiopancreatography (MRCP) for staging of ampullary tumors. Strong recommendation, low quality evidence. 3 ESGE recommends endoscopic papillectomy in patients with ampullary adenoma without intraductal extension, because of good results regarding outcome (technical and clinical success, morbidity, and recurrence). Strong recommendation, moderate quality evidence. 4 ESGE recommends en bloc resection of ampullary adenomas up to 20-30mm in diameter to achieve R0 resection, for optimizing the complete resection rate, providing optimal histopathology, and reduction of the recurrence rate after endoscopic papillectomy. Strong recommendation, low quality evidence. 5 ESGE suggests considering surgical treatment of ampullary adenomas when endoscopic resection is not feasible for technical reasons (e.g. diverticulum, size >4cm), and in the case of intraductal involvement (of >20mm). Surveillance thereafter is still mandatory. Weak recommendation, low quality evidence. 6 ESGE recommends direct snare resection without submucosal injection for endoscopic papillectomy. Strong recommendation, moderate quality evidence. 7 ESGE recommends prophylactic pancreatic duct stenting to reduce the risk of pancreatitis after endoscopic papillectomy. Strong recommendation, moderate quality evidence. 8 ESGE recommends long-term monitoring of patients after endoscopic papillectomy or surgical ampullectomy, based on duodenoscopy with biopsies of the scar and of any abnormal area, within the first 3 months, at 6 and 12 months, and thereafter yearly for at least 5 years. Strong recommendation, low quality evidence.