Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors
Background/Aims Bleeding is a complication of endoscopic snare papillectomy for ampullary tumors. This study aimed to investigate the clinical efficacy of hypertonic saline-epinephrine (HSE) local injection before endoscopic papillectomy for prevention of bleeding. Methods We retrospectively reviewe...
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Hoon Jai Chun
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doaj-ed5cb45126b44b07b8ed72a117eafd732021-10-07T00:59:22ZengHoon Jai ChunClinical Endoscopy2234-24002234-24432021-09-0154570671210.5946/ce.2020.2087491Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary TumorsNaoki Okano0Yoshinori Igarashi1Ken Ito2Saori Mizutani3Hiroki Nakagawa4Kouji Watanabe5Yuuto Yamada6Kensuke Yoshimoto7Yuusuke Kimura8Susumu Iwasaki9Kensuke Takuma10Seiichi Hara11Yuui Kishimoto12 Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, JapanBackground/Aims Bleeding is a complication of endoscopic snare papillectomy for ampullary tumors. This study aimed to investigate the clinical efficacy of hypertonic saline-epinephrine (HSE) local injection before endoscopic papillectomy for prevention of bleeding. Methods We retrospectively reviewed the data of 107 consecutive patients with ampullary tumors who underwent endoscopic papillectomy. The rates of en bloc resection, pathological resection margins, and prevention of immediate or delayed bleeding in the simple snaring resection group (Group A) and the HSE injection group (Group B) were compared. Results A total of 44 and 63 patients were enrolled in Groups A and B, respectively. The total complete resection rate was 89.7% (96/107); the clinical complete resection rates in Group A and Group B were 86.3% (38/44) and 92.1% (58/63), respectively (p=0.354). Post-papillectomy bleeding occurred in 22 patients. In Groups A and B, the immediate bleeding rates were 20.5% (9/44) and 4.8% (3/63), respectively (p=0.0255), while the delayed bleeding rates were 7% (3/44) and 11% (7/63), respectively (p=0.52). The rates of positive horizontal and vertical pathological margin in both groups were 27% and 16%, respectively. Conclusions HSE local injection was effective in preventing immediate bleeding and was useful for safely performing endoscopic papillectomy for ampullary tumors.http://www.e-ce.org/upload/pdf/ce-2020-208.pdfampullary tumorcomplicationendoscopic papillectomylocal injection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naoki Okano Yoshinori Igarashi Ken Ito Saori Mizutani Hiroki Nakagawa Kouji Watanabe Yuuto Yamada Kensuke Yoshimoto Yuusuke Kimura Susumu Iwasaki Kensuke Takuma Seiichi Hara Yuui Kishimoto |
spellingShingle |
Naoki Okano Yoshinori Igarashi Ken Ito Saori Mizutani Hiroki Nakagawa Kouji Watanabe Yuuto Yamada Kensuke Yoshimoto Yuusuke Kimura Susumu Iwasaki Kensuke Takuma Seiichi Hara Yuui Kishimoto Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors Clinical Endoscopy ampullary tumor complication endoscopic papillectomy local injection |
author_facet |
Naoki Okano Yoshinori Igarashi Ken Ito Saori Mizutani Hiroki Nakagawa Kouji Watanabe Yuuto Yamada Kensuke Yoshimoto Yuusuke Kimura Susumu Iwasaki Kensuke Takuma Seiichi Hara Yuui Kishimoto |
author_sort |
Naoki Okano |
title |
Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors |
title_short |
Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors |
title_full |
Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors |
title_fullStr |
Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors |
title_full_unstemmed |
Efficacy of Hypertonic Saline-Epinephrine Local Injection Around the Anal Side before Endoscopic Papillectomy for Ampullary Tumors |
title_sort |
efficacy of hypertonic saline-epinephrine local injection around the anal side before endoscopic papillectomy for ampullary tumors |
publisher |
Hoon Jai Chun |
series |
Clinical Endoscopy |
issn |
2234-2400 2234-2443 |
publishDate |
2021-09-01 |
description |
Background/Aims Bleeding is a complication of endoscopic snare papillectomy for ampullary tumors. This study aimed to investigate the clinical efficacy of hypertonic saline-epinephrine (HSE) local injection before endoscopic papillectomy for prevention of bleeding. Methods We retrospectively reviewed the data of 107 consecutive patients with ampullary tumors who underwent endoscopic papillectomy. The rates of en bloc resection, pathological resection margins, and prevention of immediate or delayed bleeding in the simple snaring resection group (Group A) and the HSE injection group (Group B) were compared. Results A total of 44 and 63 patients were enrolled in Groups A and B, respectively. The total complete resection rate was 89.7% (96/107); the clinical complete resection rates in Group A and Group B were 86.3% (38/44) and 92.1% (58/63), respectively (p=0.354). Post-papillectomy bleeding occurred in 22 patients. In Groups A and B, the immediate bleeding rates were 20.5% (9/44) and 4.8% (3/63), respectively (p=0.0255), while the delayed bleeding rates were 7% (3/44) and 11% (7/63), respectively (p=0.52). The rates of positive horizontal and vertical pathological margin in both groups were 27% and 16%, respectively. Conclusions HSE local injection was effective in preventing immediate bleeding and was useful for safely performing endoscopic papillectomy for ampullary tumors. |
topic |
ampullary tumor complication endoscopic papillectomy local injection |
url |
http://www.e-ce.org/upload/pdf/ce-2020-208.pdf |
work_keys_str_mv |
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