Outcomes of Endoscopic Resection of Large Spreading Ampullary Lesions

Adenomatous polyps occurring at the major ampulla are often resected endoscopically via ampullectomy during endoscopic retrograde cholangiopancreatography (ERCP). Ampullectomy remains a relatively high-risk procedure most commonly performed at tertiary level centers. Some ampullary adenomas extend out from the ampulla and can involve a significant portion of the duodenal wall and can even spread circumferentially. Historically, these large lesions, referred to as laterally spreading lesions of the papilla (LSL-Ps), were referred for surgical treatment, most commonly pancreaticoduodenectomy.

In a recent retrospective study, investigators assessed outcomes in patients undergoing ampullectomy and widespread endoscopic mucosal resection (EMR) of…