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首页> 美国卫生研究院文献>Clinical Endoscopy >Recent Advances in Endoscopic Papillectomy for Ampulla of Vater Tumors: Endoscopic Ultrasonography Intraductal Ultrasonography and Pancreatic Stent Placement
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Recent Advances in Endoscopic Papillectomy for Ampulla of Vater Tumors: Endoscopic Ultrasonography Intraductal Ultrasonography and Pancreatic Stent Placement

机译：内镜超声乳头切除术治疗壶腹肿瘤的最新进展：内镜超声检查导管内超声检查和胰腺支架置入术

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摘要

Since it was first described nearly three decades ago, endoscopic papillectomy (EP) has been utilized as a less invasive, alternative therapy for adenoma of the major duodenal papilla. In this article, we review the recent advances in EP, especially those pertaining to endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS), and pancreatic stent placement for the prevention of postpapillectomy pancreatitis. Because EUS and IDUS have similar diagnostic accuracies, either modality can be used for the preprocedural evaluation of ampullary tumors. Nevertheless, further technical refinements are required for a more precise evaluation. Given the paucity of data on the usefulness of EUS and/or IDUS during follow-up after EP, a well-designed study is warranted. Furthermore, pancreatic stent placement appears to have a protective effect against postpapillectomy pancreatitis; however, a prospective, randomized, controlled study with a larger number of patients is needed to assess this finding. Moreover, since pancreatic stent placement after EP is not always successful, various novel techniques have been developed to ensure reliable stent placement. Despite the recent advances in EP, further technical refinements and studies are needed to confirm their efficacy.
机译：自从近三十年前首次对其进行描述以来，内窥镜乳头切除术（EP）已被用作主要十二指肠乳头腺瘤的侵入性较小的替代疗法。在本文中，我们回顾了EP的最新进展，特别是与内镜超声检查（EUS），导管内超声检查（IDUS）和胰支架置入有关的最新进展，以预防papillectomy胰腺炎。由于EUS和IDUS具有相似的诊断准确性，因此两种方式均可用于壶腹肿瘤的术前评估。但是，需要进行进一步的技术改进以进行更精确的评估。鉴于EP随访期间EUS和/或IDUS有用性的数据很少，因此必须进行精心设计的研究。此外，胰腺支架置入似乎对宫颈切除术后胰腺炎具有保护作用；但是，需要一项针对大量患者的前瞻性，随机对照研究来评估这一发现。而且，由于在EP之后的胰腺支架置入并不总是成功的，因此已经开发出各种新颖的技术来确保可靠的支架置入。尽管EP的最新进展，仍需要进一步的技术改进和研究以确认其功效。

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