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Meta-Analysis
. 2023 Jul;37(7):5022-5044.
doi: 10.1007/s00464-023-10083-0. Epub 2023 May 23.

Long-term recurrence after endoscopic versus surgical ampullectomy of sporadic ampullary adenomas: a systematic review and meta-analysis

Rajat Garg #  1 , Komal Thind #  2 , Jaideep Bhalla  2 , Marian T Simonson  3 , C Roberto Simons-Linares  1 , Amandeep Singh  1 , Daniel Joyce  4 , Prabhleen Chahal  5
Affiliations
Meta-Analysis

Long-term recurrence after endoscopic versus surgical ampullectomy of sporadic ampullary adenomas: a systematic review and meta-analysis

Rajat Garg et al. Surg Endosc. 2023 Jul.

Abstract

Background and aims: Ampullary adenomas are treated both surgically and endoscopically, however, data comparing both techniques are lacking. We aimed to compare long-term recurrence of benign sporadic adenomas after endoscopic (EA) and surgical ampullectomy (SA).

Methods: A comprehensive literature search of multiple databases (until December 29, 2020) was performed to identify studies reporting outcomes of EA or SA of benign sporadic ampullary adenomas. The outcome was recurrence rate at 1 year, 2-year, 3 year and 5 years after EA and SA.

Results: A total of 39 studies with 1753 patients (1468 EA [age 61.1 ± 4.0 years, size 16.1 ± 4.0 mm], 285 SA [mean age 61.6 ± 4.48 years, size 22.7 ± 5.4 mm]) were included in the analysis. At year 1, pooled recurrence rate of EA was 13.0% (95% confidence interval [CI] 10.5-15.9], I2 = 31%) as compared to SA 14.1% (95% CI 9.5-20.3 I2 = 15.8%) (p = 0.82). Two (12.5%, [95% CI, 8.9-17.2] vs. 14.3 [95% CI, 9.1-21.6], p = 0.63), three (13.3%, [95% CI, 7.3-21.6] vs. 12.9 [95% CI, 7.3-21.6], p = 0.94) and 5 years (15.7%, [95% CI, 7.8-29.1] vs. 17.6% [95% CI, 6.2-40.8], p = 0.85) recurrence rate were comparable after EA and SA. On meta-regression, age, size of lesion or enbloc and complete resection were not significant predictors of recurrence.

Conclusion: EA and SA of sporadic adenomas have similar recurrence rates at 1, 2, 3 and 5 years of follow up.

Keywords: Ampulla; Ampullary adenoma; Endoscopic ampullectomy; Pancreaticoduodenal resection; Papillectomy; Surgical ampullectomy; Transduodenal resection.

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References

    1. Fischer HP, Zhou H (2004) Pathogenesis of carcinoma of the papilla of Vater. J Hepatobiliary Pancreat Surg 11:301–309 - PubMed - DOI
    1. Sato T, Konishi K, Kimura H et al (1999) Adenoma and tiny carcinoma in adenoma of the papilla of Vater–p53 and PCNA. Hepatogastroenterology 46:1959–1962 - PubMed
    1. Seifert E, Schulte F, Stolte M (1992) Adenoma and carcinoma of the duodenum and papilla of Vater: a clinicopathologic study. Am J Gastroenterol 87:37–42 - PubMed
    1. Offerhaus GJ, Giardiello FM, Krush AJ et al (1992) The risk of upper gastrointestinal cancer in familial adenomatous polyposis. Gastroenterology 102:1980–1982 - PubMed - DOI
    1. Burke CA, Beck GJ, Church JM et al (1999) The natural history of untreated duodenal and ampullary adenomas in patients with familial adenomatous polyposis followed in an endoscopic surveillance program. Gastrointest Endosc 49:358–364 - PubMed - DOI

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