علاج ورم الغدة الحليمية بوصفه ورماً منتشراً جانبياً يشمل الحليمة (LST-p)

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 recommends that a laterally spreading tumor involving the papilla (LST-p) can be managed by endoscopic resection, but the higher risk of intraprocedural and delayed bleeding should be taken into consideration.
• ESGE recommends performing submucosal injection prior to resection of laterally spreading duodenal ampullary tumors to allow safe and effective endoscopic mucosal resection (EMR), in line with the resection technique for epithelial nonampullary duodenal lesions.
• ESGE suggests routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic papillectomy in all patients without contraindication to administration of nonsteroidal anti-inflammatory drugs.
• ESGE recommends prophylactic pancreatic duct stenting to reduce the risk of pancreatitis after endoscopic papillectomy.