Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors

Naoki Okano; Yoshinori Igarashi; Ken Ito; Saori Mizutani; Hiroki Nakagawa; Kouji Watanabe; Yuuto Yamada; Kensuke Yoshimoto; Yuusuke Kimura; Susumu Iwasaki; Kensuke Takuma; Seiichi Hara; Yuui Kishimoto

doi:10.5946/ce.2020.208

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자료유형: 학술저널

저자정보: Naoki Okano (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Yoshinori Igarashi (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Ken Ito (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Saori Mizutani (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Hiroki Nakagawa (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Kouji Watanabe (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Yuuto Yamada (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Kensuke Yoshimoto (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Yuusuke Kimura (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Susumu Iwasaki (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Kensuke Takuma (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Seiichi Hara (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan) Yuui Kishimoto (Division of Gastroenterology and Hepatology Toho University Omori Medical Center Tokyo Japan)

저널정보: 대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제54권 제5호

발행연도: 2021.9

수록면: 706 - 712 (7page)

DOI: 10.5946/ce.2020.208

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Background/Aims: Bleeding is a complication of endoscopic snare papillectomy for ampullary tumors. This study aimed toinvestigate the clinical efficacy of hypertonic saline-epinephrine (HSE) local injection before endoscopic papillectomy for preventionof bleeding. Methods: We retrospectively reviewed the data of 107 consecutive patients with ampullary tumors who underwent endoscopicpapillectomy. The rates of en bloc resection, pathological resection margins, and prevention of immediate or delayed bleeding in thesimple snaring resection group (Group A) and the HSE injection group (Group B) were compared. Results: A total of 44 and 63 patients were enrolled in Groups A and B, respectively. The total complete resection rate was 89.7%(96/107); the clinical complete resection rates in Group A and Group B were 86.3% (38/44) and 92.1% (58/63), respectively (p=0.354). Post-papillectomy bleeding occurred in 22 patients. In Groups A and B, the immediate bleeding rates were 20.5% (9/44) and 4.8%(3/63), respectively (p=0.0255), while the delayed bleeding rates were 7% (3/44) and 11% (7/63), respectively (p=0.52). The rates ofpositive horizontal and vertical pathological margin in both groups were 27% and 16%, respectively. Conclusions: HSE local injection was effective in preventing immediate bleeding and was useful for safely performing endoscopicpapillectomy for ampullary tumors.

#Ampullary tumor #Complication #Endoscopic papillectomy #Local injection

참고문헌 (22)

참고문헌 신청

Furukawa T / 1999 / [The usefulness of endoscopic resection of the adenoma of the papilla of Vater] / Gastroenterological Endoscopy 43:284~295

Binmoeller KF / 1993 / Endoscopic snare excision of benign adenomas of the papilla of Vater / Gastrointest Endosc 39:127~131

Norton ID / 2002 / Safety and outcome of endoscopic snare excision of the major duodenal papilla / Gastrointest Endosc 56:239~243

Cheng CL / 2004 / Endoscopic snare papillectomy for tumors of the duodenal papillae / Gastrointest Endosc 60:757~764

Bohnacker S / 2005 / Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth / Gastrointest Endosc 62:551~560

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