Treatment of Ampullary Adenoma as a Laterally Spreading Tumor Involving the Papilla (LST-p)

Clinical Scenario

This protocol applies to ampullary adenoma presenting as a laterally spreading tumor involving the papilla Vateri (LST-p): a laterally spreading ampullary lesion with a ≥ 10-mm extension beyond the ampullary mound, or with an extrapapillary component involving the duodenal wall that exceeds the size of the papillary adenoma itself.

Management Approach

When residual or recurrent adenoma is identified in this setting, complementary endoscopic techniques are the recommended course of action.

The full structured regimen — specific techniques, sequencing, and follow-up criteria — is available via the protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1055/a-1397-3198

A laterally spreading tumor involving the papilla Vateri (LST-p) is defined as a laterally spreading ampullary tumor with a ≥ 10-mm extension beyond the ampullary mound or with an extrapapillary component, involving the duodenal wall, that is greater than the size of the papillary adenoma.

ESGE suggests that benign residual or recurrent lesions could be effectively managed by endoscopic treatment including ablative techniques (APC) and EMR.

View source ↗