Abstract
Background Gangliocytic paraganglioma (GP) significantly affects patients' quality of life. However, studies on endoscopic papillectomy (EP) for ampullary GP are limited. We therefore evaluated the safety and efficacy of EP for treating ampullary GP. Methods We retrospectively reviewed the clinicopathological characteristics of patients with GP who underwent EP at Nagoya University Hospital and conducted a literature survey. Results We enrolled six patients with a median tumor diameter of 17 mm. Complications related to EP were observed in three patients: two experienced bleeding, one had mild acute pancreatitis, and one had perforation (duplicate patients included), all of whom improved conservatively. Five resected specimens were confined to the submucosal layer, and one was beyond the submucosal layer. All patients were monitored without surgery, and no disease recurrence was observed after a median follow-up of 73 months. A literature review identified 14 patients, and additional surgery due to a positive vertical margin after EP revealed lymph node metastasis in 2 patients. There was no disease recurrence or death. Conclusion EP led to good long-term outcomes and effectively treated ampullary GP. Considering the potential for lymph node metastasis, additional surgery is recommended if the tumor exceeds the submucosal layer.
Overview
- The study evaluates the safety and efficacy of endoscopic papillectomy (EP) for treating ampullary gangliocytic paraganglioma (GP).
- The study retrospectively reviewed the clinicopathological characteristics of patients with GP who underwent EP at Nagoya University Hospital and conducted a literature survey. Six patients were enrolled with a median tumor diameter of 17 mm. Complications related to EP were observed in three patients, and all patients were monitored without surgery, with no disease recurrence after a median follow-up of 73 months. A literature review identified 14 patients, and additional surgery due to a positive vertical margin after EP revealed lymph node metastasis in 2 patients. There was no disease recurrence or death. The study concludes that EP led to good long-term outcomes and effectively treated ampullary GP.
Comparative Analysis & Findings
- The study compared the outcomes observed under EP for ampullary GP. Complications related to EP were observed in three patients, and all patients were monitored without surgery, with no disease recurrence after a median follow-up of 73 months. A literature review identified 14 patients, and additional surgery due to a positive vertical margin after EP revealed lymph node metastasis in 2 patients. There was no disease recurrence or death. The study found that EP led to good long-term outcomes and effectively treated ampullary GP.
Implications and Future Directions
- The study's findings suggest that EP is a safe and effective treatment option for ampullary GP. However, the potential for lymph node metastasis should be considered, and additional surgery is recommended if the tumor exceeds the submucosal layer. Future research should focus on identifying predictors of lymph node metastasis and improving the accuracy of preoperative imaging to guide decision-making for additional surgery. The study highlights the importance of monitoring patients without surgery after EP and the need for long-term follow-up to assess the efficacy of EP in treating ampullary GP.