Safety and outcome of endoscopic snare excision of the major XXXX .

@entity1 @entity788 @entity850 @entity548 @entity5 @entity1412 @entity652 @entity9317
BACKGROUND: The optimal management of @entity652 is not established. Options include surgical excision, endoscopic ablative techniques, snare excision, and observation with periodic biopsies. The aims of this retrospective study were to determine the safety and outcome of snare excision of the papilla. METHODS: Twenty-eight snare excisions of the papilla were performed in 26 @entity1 . Sixteen had @entity1412 . In 22 procedures, a minisnare was used, and in 6 cases a prototype snare was designed for excision of the papilla. Pancreatic stents were placed as a prophylactic measure at the discretion of the endoscopist (n = 10). RESULTS: Histopathologically, resected tissue included 25 @entity652 , 1 inflammatory polyp, 1 invasive @entity5 . Immediate complications were @entity548 (n = 2), mild @entity788 (n = 4) and a duodenal perforation (n = 1). The presence (n = 10) or absence (n = 18) of a pancreatic stent did not correlate with subsequent @entity788 (2 in each group, p = NS). Follow-up was available for 21 @entity1 (median, 9 months; range, 2-32 months). @entity788 at the papillectomy site resulted in @entity788 in 2 @entity1 (17%) at, respectively, 4 months and 24 months. Follow-up endoscopy revealed recurrent/residual adenomatous tissue in 2 (10%). CONCLUSIONS: Snare excision of the major @entity9317 was well tolerated. Most complications were mild except for a small duodenal perforation. @entity850 of the pancreatic duct orifice with @entity788 may be a late complication.
