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Endoscopic Ampullectomy: Who, When, and How

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Advanced Pancreaticobiliary Endoscopy

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Abstract

Endoscopic ampullectomy has emerged as the primary means for therapeutic management of ampullary adenomas, a precancerous lesion of the duodenal papilla. Appropriate staging of these lesions with increasingly available modalities such as endoscopic ultrasound and endoscopic retrograde cholangiopancreatography can help guide management therapy. While surgery remains the preferred curative procedure for ampullary adenocarcinoma, the role of endoscopy continues to expand and endoscopic resection of lesions displaying high-grade dysplasia and, in selected cases, intraductal involvement continues to be explored. Special consideration is given for adenomas that arise in the setting of familial adenomatous polyposis as this impacts treatment and surveillance decisions. This chapter reviews the role of imaging and endoscopy in the evaluation and treatment of ampullary adenomas. An overview of endoscopic resection techniques and surveillance recommendations is provided.

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  1. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida College of Medicine, 1329 SW 16th Street, Room 5251, Gainesville, FL, 32608, USA

    Matthew E. Feurer M.D., M.S., Eric G. Hilgenfeldt M.D. & Peter V. Draganov M.D.

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  1. Matthew E. Feurer M.D., M.S.
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Correspondence to Peter V. Draganov M.D. .

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    Douglas G. Adler

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Feurer, M.E., Hilgenfeldt, E.G., Draganov, P.V. (2016). Endoscopic Ampullectomy: Who, When, and How. In: Adler, D. (eds) Advanced Pancreaticobiliary Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-26854-5_10

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