中国实用外科杂志2017，Vol.37Issue(8)：850-853,4.DOI:10.19538/j.cjps.issn1005-2208.2017.08.06
十二指肠乳头肿瘤行内镜切除争议与共识
Consensus and controversy on endoscopic resection of duodenal papilla tumor
周平红 1徐佳昕1
作者信息
- 1. 复旦大学附属中山医院内镜中心,上海 200032
- 折叠
摘要
Abstract
As the development of the endoscopic examination technique, the detection rate of early duodenal ampullary tumors has increased. An active surveillance is not suitable for the actual medical condition of China. Besides, because of the high incidence of adverse events and mortality, surgery for the benign tumors is not suitable. Fortunately, endoscopic papillectomy has been widely accepted for its minimal invasive and safety. All the measures should be performed to assess the neoplasms and decide the optimum therapy. Biopsy specimens are obtained and evaluated from ampullary lesions suspicious for neoplasia. Endoscopic ultrasonography (EUS) evaluation is to estimate the invasion of the neoplasm and features concerning for malignancy. And endoscopic retrograde cholangiography (ERCP) with both biliary and pancreatic duct evaluation is to assess for evidence of extension into either ductal system. Although the standard procedure for endoscopic resection remains controversial, prophylactic pancreatic duct stent placement and rectal indomethacin during papillectomy are recommended to reduce the risk of postprocedural pancreatitis. Patients undergoing endoscopic resection of ampullary neoplasms should be included in an endoscopic surveillance program to ensure complete tissue removal and assess for disease recurrence. It is recommended that individualized therapy should be selected by the comprehensive evaluation of the clinical history, combination with the skills of the endoscopist, and the balance of the adverse events and the risk of disease.关键词
十二指肠乳头肿瘤/内镜Key words
duodenal papilla tumor/endoscope分类
医药卫生引用本文复制引用
周平红,徐佳昕..十二指肠乳头肿瘤行内镜切除争议与共识[J].中国实用外科杂志,2017,37(8):850-853,4.
