Endoscopic papillectomy for ampullary adenomatous lesions: A literature review

Table 1 Endoscopic papillectomy associated complications and managements

Main complications related to EP	Therapeutics
Bleeding	Endoscopic hemostasis: (1) Injection; (2) Electrocoagulation; and (3) Endoclips
	Vascular intervention
	Surgical intervention
Pancreatitis	Prophylactic medical therapy: (1) NSAIDs such as indometacin, etc.; (2) Hydration such as Ringer’s lactate solution; and (3) Somatostatin or octreotide
	Endoscopic therapy: (1) ERCP; and (2) Prophylactic pancreatic duct stenting
Perforation	Endoscopic managements: (1) Closure by endoclips; (2) Bile/pancreatic duct stenting; (3) Nasobiliary/nasopancreatic drainage; and (4) Jejunal feeding tube placement
	Ultrasound/CT-guided interventional therapy
	Surgical intervention
Cholangitis	ERCP
	EST
	Bile duct stenting
	Medical therapy such as antibiotics
Later pancreatic or biliary stenosis	ERCP
	EST
	Balloon dilation
	Stenting

CT: Computed tomography; EP: Endoscopic papillectomy; ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; NSAIDs: Nonsteroidal anti-inflammatory drugs.