EUS/IDUS and endoscopic papillectomy

In our institute, the indication of endoscopic papillectomy is set for adenoma or early cancer without tumor growth in the bile duct or the pancreatic duct. The substantial complete excision rate was 78.8%. One out of 11 incomplete excision cases was removed surgically for tumor persistence, and, as for remaining the 10 cases without persistence had been under serial observations. One case out of the serial observations had local recurrence in 5 years 5 months after papillectomy and surgical resection was performed. Further cases and long-term serial observations may be required to get evidence of an appropriate indication. In addition, for 60 cases experienced in our institute, the safety of this therapy was reviewed. We experienced bleeding (13.3%), pancreatitis (10%), and cholangitis (3.3%) as early complications, but all cases were successfully treated conservatively. There were no serious conditions as late complications, and endoscopic papillectomy was evaluated as a safe therapy.