シジマヤ　タクヤ   SHIJIMAYA TAKUYA   四十万谷　卓也    所属   関西医科大学  内科学第三講座    職種   助教
言語種別	英語
発表タイトル	Comparison of LECS group vs surgical papilloplasty group for duodenal ampullary tumors larger than 10 mm
会議名	第111回日本消化器病学会総会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎小林 三四郎，　髙橋 悠,　田原 智満,　中村 尚広，　四十万谷 卓也,　下釜 翼,　長沼 誠
発表年月日	2025/04/25
開催地 （都市, 国名）	東京　京王プラザホテル
開催期間	2025/04/24～2025/04/26
学会抄録	ウェブ
概要	［Background］ 　Due to advances in endoscopic diagnosis, the detection rate of duodenal tumors is increasing. Endoscopic treatment of non-ampullary tumors is becoming established, but remains controversial for ampullary tumors. 　Endoscopic papillectomy, ESD, and surgical papilloplasty（SP）have been reported as treatment strategies for duodenal ampullary adenomas. 　At our institution, we have recently started laparoscopic endoscopic cooperative surgery（LECS）for ampullary tumors larger than 10 mm. The procedure consists of ESD for ampullary tumors, placement of a drainage tube by laparoendoscopy and finally placement of ENBD and ENPD tubes. ［Methods.］ 　We retrospectively reviewed 10 patients with ampullary tumors larger than 10 mm at our hospital from 2013 to 2023. Four and six of them underwent LECS and SP, respectively. The outcomes of these two groups were compared. ［Results.］ 　Endoscopic findings showed that 7 patients had type 0-I（LECS：SP = 2：5）and 3 patients had type 0-IIa（LECS：SP = 2：1）Median tumor size for LECS/SP was 21.5（10-35）/16.5（10-20）mm. The R0 resection rate for both groups was 100％, and the recurrence rate was 0％. 　The length of hospital stay in the LECS and SP groups was 15（12-16）/16（11-58）days. There were no postoperative complications in the LECS group, while intra-abdominal infections occurred in 2 of 6 patients（33％）in the SP group. ［Conclusion.］ 　These results suggest that LECS is acceptable for ampullary adenomas compared to SP. 　We will present LECS method with videos.