A prospective multicenter study of submucosal injection to improve endoscopic snare papillectomy for ampullary adenoma
DC Field | Value | Language |
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dc.contributor.author | Hyun, Jong Jin | - |
dc.contributor.author | Lee, Tae Hoon | - |
dc.contributor.author | Park, Jin-Seok | - |
dc.contributor.author | Han, Joung-Ho | - |
dc.contributor.author | Jeong, Seok | - |
dc.contributor.author | Park, Seon Mee | - |
dc.contributor.author | Lee, Hong Sik | - |
dc.contributor.author | Moon, Jong Ho | - |
dc.contributor.author | Park, Sang-Heum | - |
dc.date.accessioned | 2021-09-03T07:51:26Z | - |
dc.date.available | 2021-09-03T07:51:26Z | - |
dc.date.created | 2021-06-16 | - |
dc.date.issued | 2017-04 | - |
dc.identifier.issn | 0016-5107 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/83978 | - |
dc.description.abstract | Background and Aims: Whether or not submucosal injection of a diluted epinephrine solution should be used to lift ampullary tumors during endoscopic snare papillectomy is unclear. This study aimed to investigate the clinical efficacy of a simple snaring method versus submucosal injection for papillectomy. Methods: A prospective multicenter study was performed at 4 tertiary referral centers. Patients with papillary lesions were randomized to undergo either simple snare papillectomy (SSP) or submucosal injection papillectomy (SIP) using 1: 10,000 diluted epinephrine. The main outcome measures were complete resection rate and post-papillectomy adverse events. Results: A total of 50 patients with biopsy-proven papillary adenomas were enrolled. Complete resection rates in the SSP and SIP groups were 80.8% (21/26) and 50.0% (12/24), respectively (P = .02). However, tumor persistence at 1 month (15.4% vs 8.3%, P = .62) and recurrence at 12 months (12.0% vs 9.5%, P = .58) did not differ despite initial differences in the prevalence of a positive resection margin. The mean tumor size was 12 mm in the SSP group and 9.29 mm in the SIP group. Post-papillectomy bleeding developed in 42.3% (11/26) and 45.8% (11/24) of patients, respectively (P = .80). Delayed bleeding (>12 h) occurred in 27.3% (3/11) and 36.4% (4/11) of patients, respectively (P = .50). Post-procedure pancreatitis occurred in 15.4% (4/26) and 25% (6/24) of patients, respectively (P = .49). Pancreatitis severity did not differ between the groups, and there were no procedure-related mortalities. Conclusions: Although the recurrence rate was similar between the SSP and SIP groups, SIP showed no advantage over SSP in terms of achieving complete resection or decreasing the frequency of post-papillectomy adverse events, such as bleeding. SSP may thus be a simpler and primarily recommendable technique. (Clinical trial registration number: NCT02165852.) | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | MOSBY-ELSEVIER | - |
dc.subject | MAJOR DUODENAL PAPILLA | - |
dc.subject | BENIGN-TUMORS | - |
dc.subject | VATER | - |
dc.subject | MANAGEMENT | - |
dc.subject | CARCINOMA | - |
dc.subject | COMPLICATIONS | - |
dc.subject | EXCISION | - |
dc.subject | THERAPY | - |
dc.title | A prospective multicenter study of submucosal injection to improve endoscopic snare papillectomy for ampullary adenoma | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Hyun, Jong Jin | - |
dc.contributor.affiliatedAuthor | Lee, Hong Sik | - |
dc.identifier.doi | 10.1016/j.gie.2016.08.013 | - |
dc.identifier.scopusid | 2-s2.0-85001022726 | - |
dc.identifier.wosid | 000401104700010 | - |
dc.identifier.bibliographicCitation | GASTROINTESTINAL ENDOSCOPY, v.85, no.4, pp.746 - 755 | - |
dc.relation.isPartOf | GASTROINTESTINAL ENDOSCOPY | - |
dc.citation.title | GASTROINTESTINAL ENDOSCOPY | - |
dc.citation.volume | 85 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 746 | - |
dc.citation.endPage | 755 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Gastroenterology & Hepatology | - |
dc.relation.journalWebOfScienceCategory | Gastroenterology & Hepatology | - |
dc.subject.keywordPlus | MAJOR DUODENAL PAPILLA | - |
dc.subject.keywordPlus | BENIGN-TUMORS | - |
dc.subject.keywordPlus | VATER | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | CARCINOMA | - |
dc.subject.keywordPlus | COMPLICATIONS | - |
dc.subject.keywordPlus | EXCISION | - |
dc.subject.keywordPlus | THERAPY | - |
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