Outcomes of endoscopic papillectomy after an insulated plastic pancreatic stent placement
절연 플라스틱 췌장 스텐트 삽입 후 시행한 내시경적 유두부절제술의 효과
- 주제(키워드) endoscopic papillectomy , pancreatitis , insulated plastic pancreatic stent , ampullary adenoma , PTFE plastic stent
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 양민재
- 발행년도 2024
- 학위수여년월 2024. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000033683
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Outcomes of endoscopic papillectomy after an insulated plastic pancreatic stent placement Background and aim: Insulated plastic pancreatic stent placement before endoscopic papillectomy (EP) was introduced to avoid technical difficulty in post- EP pancreatic stenting and ensure safe hemostatic procedure in case of post-EP bleeding by securing the pancreatic orifice. In the present study, we evaluated this procedure's technical success, adverse events, and long-term outcomes. Methods: Eighty-four patients who underwent EP for ampullary adenoma between August 2006 and December 2020 were retrospectively enrolled for long-term outcome analysis. 5-Fr polytetrafluoroethylene-insulated hand-made pancreatic stent was used in this study. Results: EP after pancreatic stents were successfully performed in 73/84 patients (86.9 %). En bloc resection was performed in 59/73 patients (80.8 %), and complete resection was achieved in 63/73 patients (86.3 %). Delayed bleeding was encountered in 7 (9.6 %) based on consensus guideline and 24 (32.9 %) on the extended definition, respectively. The incidence of pancreatitis was non- significantly less frequent in the pre-EP pancreatic stenting group than post-EP pancreatic stenting group (6.8 vs. 18.2 %; P=0.205). In the complete resection cases, tumor recurrence was encountered in 6 patients (8.2 %) with surveillance for a median of 24 months. Long-termly, 1 case (1.4 %) of cholangitis and 4 cases (5.5 %) of papillary strictures were developed. Conclusion: The current study suggested that the EP technique after pre-EP pancreatic stent placement using an insulated PTFE plastic stent may become a reliable alternative therapy to conventional EP, considering the feasibility of pancreatic stent placement, en-bloc resectability, safety of the EP, and long-term oncologic prognosis. Keywords: endoscopic papillectomy, pancreatitis, insulated plastic pancreatic stent, ampullary adenoma, PTFE plastic stent
more목차
I. INTRODUCTION 1
II. METHODS 3
A. Patients and study design 3
B. Endoscopic procedure 3
C. Surveillance 4
D. Outcome measurement 5
E. Statistical analyses 6
III. RESULTS 7
A. Patient characteristics, procedure details, and final diagnosis 7
B. Adverse events 7
C. Follow-up 8
IV. DISCUSSION 10
V. CONCLUSION 14
REFERENCES 22
국문 요약 26
