Role of Endoscopy in Ampullary and Duodenal Adenomas

Publication Date: November 1, 2015
Last Updated: March 14, 2022


Recommendations

We recommend that biopsy specimens be obtained and evaluated from ampullary lesions suspicious for neoplasia before attempted endoscopic resection. (⊕⊕⊕o)
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We recommend EUS for large ampullary lesions or duodenal polyps with features concerning for malignancy before endoscopic or surgical resection. (⊕⊕⊕o)
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We suggest ERCP with both biliary and pancreatic duct evaluation at the time of endoscopic papillectomy to assess for evidence of extension into either ductal system. (⊕⊕oo)
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We recommend prophylactic pancreatic duct stent placement and rectal indomethacin during papillectomy to reduce the risk of postprocedural pancreatitis. (⊕⊕⊕o)
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We recommend that patients undergoing endoscopic removal of ampullary and duodenal neoplasms be included in an endoscopic surveillance program to ensure complete tissue removal and assess for disease recurrence. (⊕⊕⊕o)
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We suggest that patients with sporadic ampullary or duodenal adenomas be offered screening colonoscopy. (⊕⊕oo)
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Recommendation Grading

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Overview

Title

Role of Endoscopy in Ampullary and Duodenal Adenomas

Authoring Organization

Publication Month/Year

November 1, 2015

Last Updated Month/Year

January 10, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient

Intended Users

Medical assistant, laboratory technician, nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis, Prevention

Diseases/Conditions (MeSH)

D016099 - Endoscopy, Gastrointestinal, D041742 - Upper Gastrointestinal Tract, D004379 - Duodenal Neoplasms, D005767 - Gastrointestinal Diseases, D005770 - Gastrointestinal Neoplasms

Keywords

adenoma, gastrointestinal endoscopy, ampulla, duodenal adenoma

Source Citation

Chathadi, K. V., Khashab, M. A., Acosta, R. D., Chandrasekhara, V., Eloubeidi, M. A., Faulx, A. L., … DeWitt, J. M. (2015). The role of endoscopy in ampullary and duodenal adenomas. Gastrointestinal Endoscopy, 82(5), 773–781. doi:10.1016/j.gie.2015.06.027

Methodology

Number of Source Documents
113
Literature Search Start Date
January 1, 1980
Literature Search End Date
November 1, 2013