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Open AccessArticle

A Comparison of Clinical Outcomes between Endoscopic Resection and Surgical Resection in Ampullary Tumors

1
Department of Pathology, Daejeon Eulji University Hospital, Eulji University School of Medicine, Daejeon 35233, Korea
2
Department of Internal Medicine, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul 01830, Korea
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(10), 546; https://doi.org/10.3390/medicina56100546
Received: 7 September 2020 / Revised: 5 October 2020 / Accepted: 16 October 2020 / Published: 18 October 2020
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
Background and objectives: This study aimed to elucidate the clinical outcomes of endoscopic resection (ER) through comparison with surgical resection (SR) through a meta-analysis. Materials and Methods: This meta-analysis was performed using 32 studies. The complete resection and recurrence rates of treatment for ampullary tumors were investigated and compared between ER and SR. In addition, complications, including pancreatitis, cholangitis, cholecystitis, perforation, and papillary stenosis, and mortality of ER and SR, respectively, were estimated. Results: The rates of complete resection were 0.812 (95% confidence interval, CI, 0.758–0.856) and 0.929 (95% CI 0.739–0.984) in ER and SR, respectively. Recurrence rates were 0.145 (95% CI 0.107–0.193) and 0.126 (95% CI 0.057–0.257) in ER and SR, respectively. There were no significant differences in complete resection and recurrence rates between ER and SR in the meta-regression tests (p = 0.164 and p = 0.844, respectively). The estimated rates of pancreatitis, cholangitis/cholecystitis, perforation, and papillary stenosis were 12.8%, 4.4%, 5.2%, and 4.3% in ER and 9.9%, 5.6%, 2.3%, and 5.6% in SR, respectively. There was no significant difference in complications between ER and SR. The mortality rate of SR was slightly higher than that of ER (0.041, 95% CI 0.015–0.107 vs. 0.031, 95% CI 0.005–0.162). Our results show that ER had no significant differences in terms of complete resection and recurrence rates compared to SR, regardless of tumor behaviors. Conclusions: By comparing the complication and mortality rates between ER and SR, the safety of ER was proven. View Full-Text
Keywords: ampullary tumor; endoscopic resection; surgical resection; meta-analysis ampullary tumor; endoscopic resection; surgical resection; meta-analysis
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Pyo, J.-S.; Son, B.K.; Lee, H.Y.; Oh, I.H.; Chung, K.H. A Comparison of Clinical Outcomes between Endoscopic Resection and Surgical Resection in Ampullary Tumors. Medicina 2020, 56, 546.

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