Zhang M, Liu J, Zhou PL, Zhao Q, Yang Z. Clinical outcomes of endoscopic papillectomy: The experience in a Chinese tertiary hospital. World J Gastrointest Surg 2026; 18(9): 122154 [DOI: 10.4240/wjgs.122154]
Corresponding Author of This Article
Zhuo Yang, MD, Chief Physician, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China. yangzhuocy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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research-article
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Zhang M, Liu J, Zhou PL, Zhao Q, Yang Z. Clinical outcomes of endoscopic papillectomy: The experience in a Chinese tertiary hospital. World J Gastrointest Surg 2026; 18(9): 122154 [DOI: 10.4240/wjgs.122154]
World J Gastrointest Surg. Sep 27, 2026; 18(9): 122154 Published online Sep 27, 2026. doi: 10.4240/wjgs.122154
Clinical outcomes of endoscopic papillectomy: The experience in a Chinese tertiary hospital
Meng Zhang, Jiao Liu, Pei-Lin Zhou, Qian Zhao, Zhuo Yang
Meng Zhang, Jiao Liu, Pei-Lin Zhou, Qian Zhao, Zhuo Yang, Department of Endoscopy, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
Co-first authors: Meng Zhang and Jiao Liu.
Co-corresponding authors: Qian Zhao and Zhuo Yang.
Author contributions: Zhang M, Liu J, and Yang Z significantly contributed to the conceptualization and design; Zhang M and Zhou PL conducted the literature search and data collection; Zhang M and Liu J conducted the manuscript drafting and they contributed equally to this manuscript as co-first authors; Zhao Q and Yang Z critically revised the article and they contributed equally to this manuscript as co-corresponding authors. All authors approved the final manuscript and agree to be accountable for all aspects of the work.
Supported by Liaoning Provincial Science and Technology Program, No. 2024JH2/102600288.
Institutional review board statement: The study was reviewed and approved by the General Hospital of Northern Theater Command Institutional Review Board [approval No. Y(2025)414].
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Zhuo Yang, MD, Chief Physician, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China. yangzhuocy@163.com
Received: April 13, 2026 Revised: May 21, 2026 Accepted: June 22, 2026 Published online: September 27, 2026 Processing time: 157 Days and 14.7 Hours
Abstract
BACKGROUND
Endoscopic papillectomy (EP) is the first-line treatment for ampullary neoplasms, however, technical controversies and a substantial risk of adverse events persist. This study aimed to evaluate the clinical outcomes of EP performed according to our standardized protocol, thereby providing evidence to optimize clinical strategies.
AIM
To evaluate the outcomes of a standardized EP protocol and to identify risk factors for postprocedural pancreatitis.
METHODS
In this retrospective study, 76 consecutive patients who underwent EP at a single tertiary center were included. The standardized protocol emphasizes strategic submucosal injection, routine biliary-pancreatic double stenting, and prophylactic clip closure. The primary outcomes included complete resection rates and adverse events. Potential risk factors for post-EP pancreatitis (PEP) were also analyzed.
RESULTS
The complete resection rate was 96.0%. The incidences of PEP and delayed bleeding were 22.4% and 2.6%, respectively. No perforations or procedure-related deaths were observed. Subgroup analyses of submucosal injection, double stenting, or clip closure revealed no statistically significant differences; nevertheless, favorable trends were observed for complete resection, inflammatory complications, and delayed bleeding, respectively. Accordingly, these findings should be considered hypothesis-generating. Univariate analysis identified pre-procedural hypokalemia as the only risk factor for PEP.
CONCLUSION
The standardized EP protocol is effective and safe, and pre-procedural hypokalemia is a modifiable risk factor for PEP.
Core Tip: This single-center study presents a standardized endoscopic papillectomy protocol incorporating submucosal injection, double stenting, and clip closure, achieving high complete resection with a favorable safety profile. A key novel finding is that pre-procedural hypokalemia was identified as an independent, potentially modifiable risk factor for post-endoscopic papillectomy pancreatitis. Subgroup analyses for technical components were underpowered and hypothesis-generating only. Given the rarity of ampullary neoplasms and the difficulty of conducting prospective trials, these real-world insights offer clinically meaningful guidance while higher-level evidence is awaited.
