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

BACKGROUND Pancreaticoduodenectomy (PD) is currently the preferred surgical procedure to remove duodenal papillary adenoma. It offers a low recurrence rate, but a high rate of postoperative complications. AIM To determine the efficacy and safety of endoscopic papillectomy (EP) for duodenal papillary adenoma. METHODS This retrospective case-control study included 102 patients who received treatment at Nanjing Drum Tower Hospital between January 2010 and December 2024. Clinicopathological features, adverse events, and outcomes were compared between the two groups. RESULTS After propensity score matching for sex, year, and tumor size, 37 patients each were assigned to the PD and EP groups. All patients underwent successful removal of the diseased tissues. The pathological analysis revealed no significant differences between the two groups (P > 0.05). The PD group exhibited a significantly higher incidence of pancreatic fistula and intra-abdominal infection after surgery. Two patients in the PD group died from surgery-related complications, whereas no mortality was observed in the EP group (P = 0.152). CONCLUSION EP may be effective and safe for the removal of duodenal papillary adenoma in a minimally invasive manner, and can offer superior long-term survival compared with conventional PD.