Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.106637
Revised: April 4, 2025
Accepted: April 27, 2025
Published online: June 27, 2025
Processing time: 88 Days and 6 Hours
Endoscopic papillectomy (EP) via endoscopic retrograde cholangiopancreatography has emerged as a less invasive alternative to surgery for duodenal papillary adenomas (DPAs), which is traditionally associated with notable postoperative risks.
To compare quality of life (QoL) and outcomes between DPA patients undergoing EP vs surgical resection, and to assess the influencing factors of QoL and complications.
We conducted a retrospective, single-center analysis involving patients treated for DPA at the Drum Tower Hospital of Nanjing University Medical School from 2011 to 2023. The participants completed post-discharge telephone surveys using the 12-item short form survey to assess mental (MCS) and physical component summary (PCS) scores, with norm-based scoring where ≥ 50 denotes normal. Multivariate regression analysis adjusted for confounding variables was used to compare QoL scores.
Compared with EP patients, surgically treated patients had significantly lower PCS [median: 53.0, interquartile range (IQR): 46.0-55.1 vs 54.2, IQR: 51.7-55.9, P = 0.008] and MCS scores (median: 48.6, IQR: 41.8-56.0 vs 55.9, IQR: 51.7-60.7, P < 0.001). These disparities persisted even after adjustments for demographic and medical factors. Long-term follow-up of the EP group revealed that abdominal pain and poor sleep were factors negatively impacting PCS scores, whereas postoperative pancreatitis and hypertension were associated with lower MCS scores.
EP has emerged as a QoL-preserving alternative for patients with DPA, conditional upon ensuring equivalent efficacy and safety. QoL outcomes should be considered when choosing interventions for this patient population.
Core Tip: The detection of duodenal papillary adenomas has increased due to advancements in endoscopic techniques, although the prevalence of this condition remains low. Traditionally, surgical resection is the primary treatment, but it has significant drawbacks, such as trauma and high complication rates. Endoscopic removal methods have gained popularity because they are less invasive and better preserve postoperative quality of life. Our study uniquely compared postoperative quality of life and long-term outcomes between patients who received endoscopic and surgical treatments, identifying key factors that affect quality of life after treatment. This research supports endoscopic therapy as a patient-centered approach for managing these adenomas, highlighting the balance between curative intent and quality of life preservation.