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©The Author(s) 2019.
World J Gastroenterol. Mar 21, 2019; 25(11): 1387-1397
Published online Mar 21, 2019. doi: 10.3748/wjg.v25.i11.1387
Published online Mar 21, 2019. doi: 10.3748/wjg.v25.i11.1387
Table 1 Histopathological findings of primary tumor invasion (according to the Classification of Biliary Tract Cancers established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery: 3rd English edition)
Tis | Carcinoma in situ |
T1a | Tumor limited to mucosa |
T1b | Tumor limited to sphincter of Oddi |
T2 | Tumor invades duodenal wall |
T3a | Tumor invades pancreas within 5 mm in depth |
T3b | Tumor invades pancreas beyond 5 mm in depth |
T4 | Tumor invades peripancreatic soft tissues, or other adjacent organs or structures |
Table 2 The characteristics of all patients
Number of all EP cases | 45 |
Male/female | 29/16 |
Age (yr, mean ± SD) | 65.0 ± 11.5 |
Tumor size (mm, mean ± SD) | 21.1 ± 6.2 |
En-bloc resection/piecemeal resection | 41/4 |
Stent placement | |
Both/pancreatic/biliary/none | 33/7/4/1 |
Complications of EP | |
Post-EP bleeding | 9 (20.0%) |
Post-EP pancreatitis | 13 (28.9%) |
Hospital stay (d, mean ± SD) | 15.4 ± 8.5 |
Pathological diagnosis | |
Adenoma/adenocarcinoma | 33/12 |
Pathological evaluation of resected margin | |
Positive/uncertain/negative | 12/12/21 |
Horizontal margin | |
Positive/uncertain | 9/10 |
Vertical margin | |
Positive/uncertain | 5/9 |
Median observation period (mo, range) | 27.1 (3.0-133.4) |
Table 3 The diagnostic accuracy of endoscopic forceps biopsy before endoscopic papillectomy
Preoperative biopsy | Number | Final pathological diagnosis | |
Adenoma | Adenocarcinoma | ||
Adenoma | 30 | 28 | 2 |
Borderline | 11 | 4 | 7 |
Adenocarcinoma | 4 | 1 | 3 |
Table 4 Summary of the clinical data of the patients who developed recurrent tumors after endoscopic papillectomy
Age | Sex | Preoperative diagnosis | Final diagnosis | Size (mm) | Resection margin | Duration to recurrence (mo) | Additional treatment | Follow up periods after APC (mo) |
75 | Male | Adenoma | Adenoma | 25 | HM (+), VM (X) | 1.0 | APC | 75.9 |
60 | Female | Adenoma | Adenoma | 17 | HM (+), VM (X) | 5.0 | APC | 133.4 |
73 | Male | Borderline | Adenocarcinoma | 22 | HM (+), VM (-) | 1.2 | APC | 56.6 |
74 | Female | Adenoma | Adenoma | n/d | HM (-), VM (-) | 6.3 | APC | 71.0 |
- Citation: Sakai A, Tsujimae M, Masuda A, Iemoto T, Ashina S, Yamakawa K, Tanaka T, Tanaka S, Yamada Y, Nakano R, Sato Y, Kurosawa M, Ikegawa T, Fujigaki S, Kobayashi T, Shiomi H, Arisaka Y, Itoh T, Kodama Y. Clinical outcomes of ampullary neoplasms in resected margin positive or uncertain cases after endoscopic papillectomy. World J Gastroenterol 2019; 25(11): 1387-1397
- URL: https://www.wjgnet.com/1007-9327/full/v25/i11/1387.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i11.1387