Methods: Subjects were 83 patients with ampullary tumor (62 patients: endoscopic snare papillectomy; 21 patients: surgical resection). EUS and IDUS were performed preoperatively to evaluate focal extension as possible. Outcome was also evaluated who were treated by endoscopic snare papillectomy. Results: The final pathological diagnosis was adenoma in 36 patients, carcinoma in adenoma in 10 patients, adenocarcinoma in 27 patients, neuroendocrine tumor in 4 patients, regenerative change or hyperplasia in 6 patients. The accuracy of preoperative biopsy was 71%. EUS had diagnostic accuracy of 88% for duodenal invasion, 92% for extension into bile duct and 98% for extension
into pancreatic duct. IDUS had diagnostic accuracy of 88% for duodenal IWR-1 chemical structure invasion, 86% into bile duct and 94% into pancreatic duct. Success rate of endoscopic snare papillectomy was 89%. Follow-up endoscopy revealed recurrent/residual adenoma in 2 patients, carcinoma in adenoma in 1 selleck chemical patient and adenocarcinoma in 1 patient. 1 patient in carcinoma in adenoma
and 1 patient in adenocarcinoma were resected endoscopically, 2 patients in adenoma and 1 patient in adenocarcinoma were resected surgically. Conclusion: Endoscopic snare papillectomy is useful as complete biopsy. EUS and IDUS are highly capable of evaluating tumors of the major duodenal papilla preoperatively. However, these techniques are not sufficient to evaluate focal extension preoperatively for carcinoma. At the current point in time, endoscopic snare papillectomy is adequate at treating adenoma and carcinoma in adenoma. Key Word(s): 1. Ampullary Tumor; 2. EUS; 3. IDUS; Presenting Author: XUEFENG LU Corresponding Author: XUEFENG LU Affiliations: Qilu hospital of Shandong university Objective: Endoscopic submucosal dissection (ESD) which is a kind of minimally invasive technology is to use all kinds of electric knives to resect gastrointestinal lesions under
endoscopy. It is reported that ESD is a safe and effective method for gastrointestinal lesions with low recurrence rate, few complications, less pain and short hospitalization days. But recently it has developed a new kind of minimally invasive treatment technology isometheptene – Endoscopic Submucosal Tunnel Dissection (ESTD) on the basis of ESD. The purpose of the study is to explore the clinical value of ESTD by comparing the ESTD and ESD in the treatment of the esophageal submucosal protrusion lesions. Methods: From Jan. 2011 to Feb. 2013, 42 patients with 44 lesions in gastroesophageal submucosa were treated with ESE in Qilu Hospital of Shandong University. Efficacy and safety were evaluated based on their status. Results: 27 of the 42 patients were male. Of all the 44 lesions, 17 originated from the esophagus. The mean tumor size was 1.52 (0.5∼3.0) cm. Media age of patients were 53 (18∼67) yrs. The mean hospital stay was 8.2 (6∼12) days. Complications were evaluated in post-ESE hemorrhage and perforation.