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

doi:10.4240/wjgs.v18.i2.113698

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Feb 27, 2026 (publication date) through Feb 26, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Feb 27, 2026; 18(2): 113698
Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.113698

Table 1 Baseline characteristics of patients, n (%)

	PD (n = 37)	EP (n = 37)	t/χ²	P value
Age (year)	61.35 ± 8.11	62.83 ± 11.32	-0.649	0.518
Gender
Male	17 (45.95)	25 (67.75)	3.52	0.06
Female	20 (54.05)	12 (32.43)
Tumor size (cm)	1.94 ± 0.77	1.94 ± 0.85	0.123	0.481
Previous abdominal surgery
No	25 (67.57)	28 (75.68)	0.598	0.439
Yes	12 (32.43)	9 (24.32)
Hypertension
No	21 (56.76)	24 (64.86)	0.51	0.475
Yes	16 (43.24)	13 (35.14)
Diabetes
No	34 (91.89)	32 (86.49)	0.561	0.454
Yes	3 (8.11)	5 (13.51)
Coronary heart disease
No	36 (97.30)	35 (94.59)	0.347	0.556
Yes	1 (2.70)	2 (5.41)
Anticoagulant
No	36 (97.30)	36 (97.30)	0.01	0.99
Yes	1 (2.70)	1 (2.70)
CBC
Hemameba	6.14 ± 2.34	5.90 ± 1.48	0.534	0.595
Hemoglobin	124.70 ± 26.34	134.14 ± 19.14	-1.762	0.082
Blood platelet	212.76 ± 65.93	187.14 ± 60.09	1.747	0.085
Blood coagulation
PT	11.93 ± 1.10	12.92 ± 2.44	-2.239	0.58
APTT	26.96 ± 3.64	27.68 ± 3.95	-0.811	0.42
Biochemical function
Total bilirubin	26.59 ± 33.75	12.08 ± 5.75	2.578	0.012
Direct bilirubin	16.88 ± 26.77	3.71 ± 1.58	2.987	0.004
Albumin	39.70 ± 4.289	40.00 ± 2.45	-0.37	0.713
Urea nitrogen	4.61 ± 1.66	5.20 ± 1.42	-1.659	0.102
Creatinine	59.00 ± 12.43	68.03 ± 18.48	-2.465	0.058
Tumor marker
CA19-9	21.32 ± 27.53	13.92 ± 10.55	1.526	0.131

P < 0.05 indicated statistical significance. CBC: Complete blood count; PD: Pancreaticoduodenectomy; EP: Endoscopic papillectomy; PT: Prothrombin time; APTT: Activated partial thromboplastin time; CA19-9: Carbohydrate antigen 19-9.

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Table 2 Clinical results and complications, n (%)

	PD (n = 37)	EP (n = 37)	χ²	P value
Pathology
Adenoma	20 (54.05)	26 (70.27)	2.157	0.141
Carcinoma in situ	17 (45.95)	11 (29.73)
Biliary stent placement
No	36 (97.30)	30 (81.08)	5.045	0.025
Yes	1 (2.70)	7 (18.92)
Pancreatic stent placement
No	9 (24.32)	7 (18.92)	0.319	0.572
Yes	28 (75.68)	30 (81.08)
Complications
Hemorrhage
No	31 (83.78)	33 (89.19)	0.463	0.496
Yes	6 (16.22)	4 (10.81)
Perforation
No	35 (94.59)	36 (97.30)	0.347	0.556
Yes	2 (5.41)	1 (2.70)
Biliary fistula
No	36 (97.30)	37 (100.00)	1.014	0.314
Yes	1 (2.70)	0 (0.00)
Pancreatic fistula
No	32 (86.49)	37 (100.00)	5.362	0.021
Yes	5 (13.51)	0 (0.00)
Cholangitis
No	35 (94.59)	34 (91.89)	0.214	0.643
Yes	2 (5.41)	3 (8.11)
Pancreatitis
No	34 (91.89)	34 (91.89)	0.001	0.999
Yes	3 (8.11)	3 (8.11)
Abdominal infection
No	29 (78.38)	36 (97.30)	6.198	0.013
Yes	8 (21.62)	1 (2.70)
Mortality
No	35 (94.59)	37 (100.00)	2.056	0.152
Yes	2 (5.41)	0 (0.00)

P < 0.05 indicates statistical significance. PD: Pancreaticoduodenectomy; EP: Endoscopic papillectomy.

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Table 3 Analysis of relevant risk factors, n (%)/mean ± SD

	Non-complication (n = 49)	Complication (n = 25)	t/χ²	P value
Age (year)	62.63 ± 10.10	61.04 ± 9.33	0.658	0.513
Gender
Male	27 (55.10)	15 (60.0)	0.162	0.687
Female	22 (44.90)	10 (40.0)
Tumor diameter (cm)	1.95 ± 0.80	1.93 ± 0.83	0.124	0.902
Previous abdominal surgery
No	34 (69.39)	19 (76.0)	0.356	0.551
Yes	15 (30.61)	6 (24.0)
Hypertension
No	31 (63.27)	14 (56.0)	0.367	0.545
Yes	18 (36.73)	11 (44.0)
Diabetes
No	43 (87.76)	23 (92.0)	0.309	0.578
Yes	6 (12.24)	2 (8.0)
Coronary heart disease
No	46 (93.88)	25 (100.0)	1.595	0.207
Yes	3 (6.12)	0
CBC (24 h postoperatively)
Hemameba	8.60 ± 3.44	10.81 ± 4.51	-2.354	0.021
Hemoglobin	127.96 ± 18.12	124.28 ± 15.65	0.863	0.391
Blood coagulation
PT	12.53 ± 2.12	12.21 ± 1.57	0.685	0.496
APTT	26.63 ± 2.99	28.66 ± 4.78	-2.244	0.028
Pathology
Adenoma	25 (51.02)	12 (48.00)	0.06	0.806
Carcinoma in situ	24 (48.98)	13 (52.00)
Operation methods
PD	20 (40.82)	17 (68.00)	4.893	0.027
EP	29 (59.18)	8 (32.00)

P < 0.05 indicates statistical significance. CBC: Complete blood count; PD: Pancreaticoduodenectomy; EP: Endoscopic papillectomy; PT: Prothrombin time; APTT: Activated partial thromboplastin time.

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Table 4 Follow-up results of different treatments

	PD (n = 32)	EP (n = 35)	χ²	P value
Patients without recurrence	29	28	2.773	0.096
Dead patients	4	0
Living patients	25	28
Patients with recurrence	3	7	2.628	1.000
Radiofrequency ablation	0	5
Surgical treatment	0	2
Observation	3	0

P < 0.05 indicates statistical significance. PD: Pancreaticoduodenectomy; EP: Endoscopic papillectomy.

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Citation: Xu L, Chen SJ, Wang P, Mao L, Zou XP, Wang L, Wang Y. Safety and efficacy of endoscopic papillectomy for duodenal papillary adenomas: A single-center retrospective study. World J Gastrointest Surg 2026; 18(2): 113698
URL: https://www.wjgnet.com/1948-9366/full/v18/i2/113698.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i2.113698