Endoscopic treatment for tumors of the minor duodenal papilla: a case series and literature review

Abstract Background and aims Although current guidelines recommend endoscopic papillectomy (EP) as the first-line intervention for noninvasive ampullary tumors, there is no consensus on its use for tumors of the minor duodenal papilla (Midp). Therefore, this study aims to evaluate the efficacy and safety of EP for Midp tumors based on our experience and a review of the literature. Methods The study involved two steps: first, a retrospective, single-center analysis of Midp tumors treated at our hospital, and second, a literature review to assess the procedures and outcomes of EP for Midp tumors. Results EP was successfully performed in five patients with Midp tumors at our hospital, with no adverse events reported. Complete resection (R0 resection) was achieved in three cases, and all five patients remained recurrence-free during follow-up. Among 93 cases from 31 articles included in the literature review, 86.57% (58/67) of patients achieved complete resection (R0 resection). Residual lesions were observed in 7.94% (5/63) of patients, but additional treatments such as argon plasma coagulation or repeat EP achieved favorable outcomes. No severe complications were reported, and all patients recovered with conservative management. Adenoma recurrence was observed in 3.23% (3/93) of patients during follow-up. Two of these patients underwent repeat endoscopic treatment and recovered successfully. Conclusions This study demonstrates that EP is a safe and effective treatment for tumors of the minor duodenal papilla. The short-term and long-term outcomes of EP are acceptable, and repeat endoscopic treatment is feasible for achieving clinical cure in cases of tumor recurrence.