{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:36:25Z","timestamp":1790253385968,"version":"4.1.0"},"reference-count":186,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Main Recommendations<\/jats:title>\n                  <jats:p>1 ESGE recommends against diagnostic\/therapeutic papillectomy when adenoma is not proven.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>2 ESGE recommends endoscopic ultrasound and abdominal magnetic resonance cholangiopancreatography (MRCP) for staging of ampullary tumors.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>3 ESGE recommends endoscopic papillectomy in patients with ampullary adenoma without intraductal extension, because of good results regarding outcome (technical and clinical success, morbidity, and recurrence).Strong recommendation, moderate quality evidence.<\/jats:p>\n                  <jats:p>4 ESGE recommends en bloc resection of ampullary adenomas up to 20\u201330\u200amm in diameter to achieve R0 resection, for optimizing the complete resection rate, providing optimal histopathology, and reduction of the recurrence rate after endoscopic papillectomy.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>5 ESGE suggests considering surgical treatment of ampullary adenomas when endoscopic resection is not feasible for technical reasons (e.\u200ag. diverticulum, size &gt;\u200a4\u200acm), and in the case of intraductal involvement (of &gt;\u200a20\u200amm). Surveillance thereafter is still mandatory.<\/jats:p>\n                  <jats:p>Weak recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>6 ESGE recommends direct snare resection without submucosal injection for endoscopic papillectomy.Strong recommendation, moderate quality evidence.<\/jats:p>\n                  <jats:p>7 ESGE recommends prophylactic pancreatic duct stenting to reduce the risk of pancreatitis after endoscopic papillectomy.<\/jats:p>\n                  <jats:p>Strong recommendation, moderate quality evidence.<\/jats:p>\n                  <jats:p>8 ESGE recommends long-term monitoring of patients after endoscopic papillectomy or surgical ampullectomy, based on duodenoscopy with biopsies of the scar and of any abnormal area, within the first 3 months, at 6 and 12 months, and thereafter yearly for at least 5 years.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>","DOI":"10.1055\/a-1397-3198","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T20:11:31Z","timestamp":1615925491000},"page":"429-448","source":"Crossref","is-referenced-by-count":175,"title":["Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline"],"prefix":"10.1055","volume":"53","author":[{"given":"Geoffroy","family":"Vanbiervliet","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Centre Hospitalier Universitaire de Nice, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marin","family":"Strijker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Arvanitakis","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Aelvoet","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Arnelo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-0428","authenticated-orcid":false,"given":"Torsten","family":"Beyna","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Evangelisches Krankenhaus D\u00fcsseldorf, Dusseldorf, Nordrhein-Westfalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-8967","authenticated-orcid":false,"given":"Pierre H.","family":"Deprez","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumir","family":"Kunovsky","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic"},{"name":"Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Larghi","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-588X","authenticated-orcid":false,"given":"Gianpiero","family":"Manes","sequence":"additional","affiliation":[{"name":"Aziende Socio Sanitaria Territoriale Rhodense, Gastroenterology, Garbagnate Milanese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Moss","sequence":"additional","affiliation":[{"name":"Department of Endoscopic Services, Western Health, Melbourne, Australia"},{"name":"Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Napoleon","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie, H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay G\u00e9n\u00e9rale de Sant\u00e9, Lyon, 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