Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 39: What Is The Best Treatment For Duodenal Or Ampullary Adenoma, And What Is The Current Recommendation For Surveillance After Treatment? (continued)

Richard A. Kozarek, MD

Ampullary tumors historically presented late, with jaundice, bleeding, relapsing pancreatitis, or duodenal obstruction, and were treated with radical pancreaticoduodenectomy and, less commonly, transduodenal resection and dual sphincteroplasty.1 Endoscopy in this setting was limited diagnostically to tissue acquisition and therapeutically to biliary stent placement or sphincterotomy in high surgical risk patients with obstructive jaundice. Currently, the majority of adenomas are found incidentally during screening for reflux or dyspepsia or follow-up of C-loop adenomas in patients with…