Safety and efficacy of endoscopic papillectomy for duodenal papillary adenomas: A single-center retrospective study

Figure 1 Flowchart of patient enrollment and treatment allocation. A total of 102 eligible patients with a single lesion in the duodenal papilla were enrolled. After propensity score matching, 74 eligible patients were enrolled in the final analysis, with 37 undergoing endoscopic papillectomy and 37 undergoing pancreaticoduodenectomy. PSM: Propensity score matching.

Figure 2 Endoscopic papillectomy for resection of duodenal papillary adenoma. A: Endoscopic visualization of duodenal papillary adenoma; B: Submucosal injection (e.g., saline with epinephrine) around the lesion to facilitate resection; C and D: En bloc snare excision of the lesion; E and F: Deployment of a 5-Fr, 3-cm pancreatic duct stent to prevent post-procedural pancreatitis, followed by closure of the mucosal defect using hemostatic clips; G: Gross view of the resected specimen; H: X-ray fluoroscopy demonstrating the pancreatic duct stent and titanium clips.

Figure 3 Histopathological evaluation of resected duodenal papillary adenoma. A: Macroscopic appearance of the formalin-fixed duodenal papillary specimen; B: Representative tissue sections prepared for histopathological examination; C–E: Hematoxylin and eosin-stained sections demonstrating the microscopic architecture of the neoplasms.

Figure 4 Pancreaticoduodenectomy for resection of duodenal papillary adenoma. A: Endoscopic visualization of a duodenal papillary adenoma; B: Endoscopic ultrasound features of duodenal papillary lesions; C–E: Gross morphology of the surgically resected specimen.