Endoscopic classification of major duodenal papilla adenomas

Abstract

   Aim. To introduce the developed endoscopic classification of major duodenal papilla adenomas.   Materials and methods. In 2000–2023 period, 149 patients with neoplasms of the major duodenal papilla underwent comprehensive examinations and surgical interventions. 134 cases involved endoscopic removal of papilla tumors.   Results. Radical removal of the major papilla adenoma was performed in 90.5 % of cases. 16.6 % of cases revealed complications as follows: postmanipulation pancreatitis in 10 (7.9 %) cases, bleeding in 7 (5.5 %), and duodenal perforation in 4 (3.1 %). 1–3 year follow-up period revealed residual adenomatous overgrowths in 9.5 % of cases. An endoscopic classification of major papilla adenomas was developed, thereby leading to a decrease in thecomplication and re-intervention rates. The classification enables the character of intraductal spread of adenomas to be specified and indications for their endoscopic excision to be determined.   Conclusion. The developed endoscopic classification of major duodenal papilla adenomas contributes to selection of the most effective and safe method of surgical intervention. An application of the classification implies unification of an endoscopic description of the tumor and consistency in patient monitoring by different specialists.