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@article{1761817, author = {Vanbiervliet, G. and Strijker, M. and Arvanitakis, M. and Aelvoet, A. and Arnelo, U. and Beyna, T. and Busch, O. and Deprez, P. H. and Kunovský, Lumír and Larghi, A. and Manes, G. and Moss, A. and Napoleon, B. and Nayar, M. and PerezandCuadradoandRobles, E. and Seewald, S. and Barthet, M. and van Hooft, J. E.}, article_location = {STUTTGART}, article_number = {04}, doi = {http://dx.doi.org/10.1055/a-1397-3198}, keywords = {ampullary tumors; endoscopic management}, language = {eng}, issn = {0013-726X}, journal = {Endoscopy}, title = {Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline}, url = {https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1397-3198}, volume = {53}, year = {2021} }
TY - JOUR ID - 1761817 AU - Vanbiervliet, G. - Strijker, M. - Arvanitakis, M. - Aelvoet, A. - Arnelo, U. - Beyna, T. - Busch, O. - Deprez, P. H. - Kunovský, Lumír - Larghi, A. - Manes, G. - Moss, A. - Napoleon, B. - Nayar, M. - Perez-Cuadrado-Robles, E. - Seewald, S. - Barthet, M. - van Hooft, J. E. PY - 2021 TI - Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline JF - Endoscopy VL - 53 IS - 04 SP - 429-448 EP - 429-448 PB - GEORG THIEME VERLAG KG SN - 0013726X KW - ampullary tumors KW - endoscopic management UR - https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1397-3198 N2 - 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. ER -
VANBIERVLIET, G., M. STRIJKER, M. ARVANITAKIS, A. AELVOET, U. ARNELO, T. BEYNA, O. BUSCH, P. H. DEPREZ, Lumír KUNOVSKÝ, A. LARGHI, G. MANES, A. MOSS, B. NAPOLEON, M. NAYAR, E. PEREZ-CUADRADO-ROBLES, S. SEEWALD, M. BARTHET and J. E. VAN HOOFT. Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. \textit{Endoscopy}. STUTTGART: GEORG THIEME VERLAG KG, 2021, vol.~53, No~04, p.~429-448. ISSN~0013-726X. Available from: https://dx.doi.org/10.1055/a-1397-3198.
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