Diagnosis and treatment of benign neoplasms of the major duodenal papilla

• Published in: Hirurgija (Moskva) no. 11; p. 32
• Main Authors: Teterin, Yu S, Yartsev, P A, Rogal, M L, Tigiev, L R, Shavrina, N V, Nugumanova, K A, Stepan, E V
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2020
• Subjects: Acute Disease; Ampulla of Vater - surgery; Common Bile Duct Neoplasms - diagnosis; Common Bile Duct Neoplasms - surgery; Duodenoscopy; Female; Humans; Male; Pancreatitis - etiology; Pancreatitis - prevention & control; Reoperation; Treatment Outcome; endoscopic papillectomy; adenoma; common bile duct; major pancreatic duct; major duodenal papilla; duodenum
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia202011132

To evaluate an efficacy of surgical treatment of patients with benign tumors of the major duodenal papilla. For the period from January 2015 to January 2020, sixteenth patients with benign tumors of the major duodenal papilla were treated at the Sklifosovsky Research Institute for Emergency Care. There were 7 men (43.7%) and 9 women (56.3%). Tumor dimension ranged from 1.0 to 4.0 cm (mean 2.5 cm). Tumor resection through laparotomy was performed in 4 (25%) patients. Six (37.5%) patients underwent endoscopic submucosal papillectomy. Other 6 (37.5%) patients refused surgical treatment due to regression of symptoms. Postoperative re-laparotomy was performed in 1 patient (10%) with acute perforated duodenal ulcer. There were no complications after endoscopic papillectomy. Control endoscopic examination identified no signs of tumor recurrence in all patients after 3 and 6 months. In our opinion, endoscopic papillectomy is preferable for adenoma of the major duodenal papilla due to reduced surgical trauma. We assume that stenting of the bile ducts and the major pancreatic duct prevented acute pancreatitis and obstructive jaundice. Endoscopic papillectomy is an effective minimally invasive treatment of tumors of the major duodenal papilla. Despite a considerable number of complications, most of them can be resolved by conservative treatment or endoscopic procedures. Thus, endoscopic papillectomy may be considered as preferable method in the treatment of patients with benign tumors of the major duodenal papilla.