The role of endoscopic classification-based typing of major duodenal papilla adenomas in the selection of surgical resection procedures

Aim. To evaluate the impact of endoscopic procedure selection in the treatment of patients with major duodenal papilla adenomas, using a newly developed endoscopic classification of these lesions. Materials and Methods. From 2000 to 2024, endoscopic surgical resection of major duodenal papilla adenomas was performed in 200 patients. Preoperative diagnosis was based on endoscopic ultrasound (EUS) in 165 cases, while in 35 cases, EUS was not used. Results. Technical success of endoscopic resection of major duodenal papilla adenomas was 100% in both groups. The incidence of postoperative complications was 16.9% in the main group and 40% in the comparison group. During long-term follow-up, the adenoma recurrence rate was 6.6% in the main group and 20% in the comparison group. Conclusion. A patient-specific choice of the optimal procedure for surgical resection of major duodenal papilla adenomas, depending on classification-based typing of the neoplasm, reduces the rate of postoperative complications and resection radicality.