Endoscopic treatment of ampullary neoplasms

Abstract

The past decade has witnessed the acceptance of endoscopic
ampulletomy as an effective technique in the management
of non-invasive ampullary neoplasms. The ideal lesion
should be smaller than 3cm and not extend into the
biliary or pancreatic ducts. Endoscopic ultrasonography is
helpful in excluding invasion prior to resection. Snare resection
can be combined with thermal techniques of fulguration
to improve success rates. Pancreatic stent placement
has led to lower rates of post-ampullectomy pancreatitis,
the major complication of the procedure. Performed in endoscopic
centers of expertise, endoscopic ampullectomy
constitutes a less morbid alternative to traditional surgical
approaches toward ampullary neoplasms