Endoscopic snare papillectomy for a solitary Peutz-Jeghers-type polyp in the duodenum with ingrowth into the common bile duct: Case report

Figure 3 Tumor resection by endoscopic snare papillectomy. A: Endoscopic retrograde cholangiopancreatography (ERCP) showing several filling defects in the upper part of the common bile duct (CBD) (black arrows), and an oval-shaped defect in the intra-pancreatic CBD (white arrows). Endoscopic picture during ERCP did not show any remarkable findings without juxtapapillary duodenal diverticula; B: Intraductal ultrasonography confirming that the lower filling defect was a papillary-growing tumor in the CBD; C: Second ERCP, performed one week later, showing inversion and exclusion of the tumor after endoscopic sphincterotomy. The tumor was a pedunculated polyp, enabling en bloc resection by endoscopic snare papillectomy.