Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
El-Mahrouk, M; El-Shabrawi, A; Langner, C; Hau, HM; Sucher, R.
Transduodenal resection of a large papillary tumor by means of intraoperative cholangioscopy.
Int J Surg Case Rep. 2024; 124: 110364
Doi: 10.1016/j.ijscr.2024.110364
(- Case Report)
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- El-Mahrouk Mohamed
- Co-Autor*innen der Med Uni Graz
- El-Shabrawi Azab Mohamed
- Hau Hans-Michael
- Langner Cord
- Sucher Robert
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- INTRODUCTION: Papillary adenomas are very rare benign tumors of the gastrointestinal tract. If manageable, purely endoscopic resection is favored. As an alternative, surgical resection via ampullectomy or pancreaticoduodenectomy can be performed. Often, the depth of infiltration cannot be assessed with sufficient precision, leading to pancreaticoduodenectomy for safety reasons. CASE PRESENTATION: We present the case of a 77-year-old patient in whom a transduodenal papillary resection of a large papillary adenoma was performed, after two unsuccessful endoscopic attempts. Intraoperatively, a 3 cm large papillary adenoma was identified in the duodenum. The infiltration depth into the Vater's papilla was evaluated through intraoperative cholangioscopy. Due to the shallow depth of invasion, we strived for a papillary resection under endoscopic guidance, allowing complete tumor removal. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. CLINICAL DISCUSSION: The decision between ampullectomy and pancreaticoduodenectomy is an intraoperative challenge. Intraoperative cholangioscopy demonstrated its potential to aid this decision-making process in this case. Larger-scale studies are needed to establish its clinical value. CONCLUSION: Intraoperative cholangiography can help surgeons assess the depth of infiltration of large papillary adenomas, leading to more precise surgical decisions about the necessary extent of resection.
- Find related publications in this database (Keywords)
- Pancreatic surgery
- Hepatobiliary surgery
- Endoscopy
- Cholangioscopy
- Case report