Endoscopic papillectomy: Data of a prospective observational study

Table 1 Spectrum and frequency of preinterventional endoscopic investigations in the whole group of patients with following endoscopic papillectomy (n = 54)

Investigation	Gastroscopy		EUS		ERCP
	w/Hx	w/o Hx	w/Hx	w/o Hx	w/Hx	w/o Hx
Case n (%)	20 (37.0)	8 (14.8)	4 (7.4)	39 (72.2)	9 (16.6)	15 (27.8)
In total (%)	51.80%		79.60%		44.40%

Hx: Histopathological finding; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Absolute and relative frequency and spectrum of various findings by preinterventional histopathological investigation and diagnostic measures as well as definitive postinterventional diagnoses n (%)

Category of single finding	Preinterventional histo-pathological finding (after taking a biopsy; n = 32)	Indications leading to endoscopic papillectomy (result of preinterventional diagnostic measures; n = 54)	Definitive histopathological findings of the specimen (after endoscopic papillectomy; n = 54)
Adenoma
Tumor mass with no malignancy	63	35 (64.8)	24 (45.0)
Adenocarcinoma	19	10 (18.5)	18 (33.0)
NET	3
Lymphoma	3
Mucosal specimen	9	/	/
Papilla into which catheter can not be introduced	/	8 (14.8)	8 (15.0)
Diagnostic papillectomy	/	1 (1.8)	/
Adenomyomatosis	/	/	4 (7.0)

NET: Neuroendocrine tumor.

Table 3 Various parameters characterizing value of preinterventional histopathological investigation (after taking a biopsy) and diagnostic measures

Parameter	Pre-interventional
	Histopathological investigation (after taking a biopsy)	Diagnostic measures
Sensitivity	64.20%	64.20%
Specificity	55.00%	65.50%
Predictive value
Negative	65.5%	65.5%
Positive	56.5%	56.5%

Table 4 Characteristics of adenoma patients after endoscopic papillectomy n (%)

	Adenoma
	In total	Resectiom status
		R0	Rx	R0 + Rx	R1	R2
Case	24	9 (37.5)	13 (54.2)	22 (91.6)	1 (4.2)	1 (4.2)
Recurrence		1 (11.1)	2 (15.4)	3 (13.6)

Rx, resection status could not be defined because of loss of specimen or no detectable adenoma cells in the resected specimen despite adenoma finding in the histopathological investigation of the preinterventional biopsy. Recurrence, only related to "R0 + Rx" according to the definition of recurrent tumor growth, namely, tumor-free resection area.

Table 5 Characteristics of patients with a malignant tumor lesion (adenocarcinoma, neuroendocrine tumor and lymphoma) after endocopic papillectomy n (%)

	In total	Resection status
		R0	Rx	R0 + Rx	R1	R2
All stages
Case	18	8 (44.4)	2 (11.1)	10 (55.5)	1 (5.5)	7 (38.8)
Recurrency		1 (12.5)	1 (50.0)	2 (20.0)
T1 stage only
Case	12	8 (66.7)	1 (8.3)	9 (75.0)	1 (8.3)	2 (16.6)
Recurrence		1 (12.5)	0 (0.0)	1 (11.1)

Rx, resection status could not be defined because of loss of specimen or no detectable adenoma cells in the resected specimen despite adenoma finding in the histopathological investigation of the preinterventional biopsy. Recurrence, only related to "R0 + Rx" according to the definition of recurrent tumor growth, namely, tumor-free resection area.

Table 6 Number and percentage of complications depending on the tumor entity and/or indication for endoscopic papillectomy n (%)

	Case (n)	Complications
Adenoma	24	3 (12.5)
Carcinoma/NET/lymphoma	18	3 (16.6)
Papilla into which catheter can not be introduced	8	2 (25.0)
Adenomyomatosis	4	2 (50.0)
In total	54	10 (18.5)
Major complication		1 (1.9)

NET: Neuroendocrine tumor.