{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:02:15Z","timestamp":1789048935585,"version":"build-2803163510"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims Noninvasive ampullary neoplasms may be removed by surgery or endoscopy. However, given the morbidity and mortality associated with surgery, endoscopic papillectomy (EP) is the preferred approach. Radiofrequency ablation (RFA) after EP has emerged as a promising alternative therapy to avoid surgery after incomplete EP. Our goal was to evaluate the efficacy and safety of RFA for residual or recurrent lesions with intraductal extension after endoscopic papillectomy.<\/jats:p><jats:p>\n            Patients and methods The inclusion criteria include clinical trials, cohort studies, and case series evaluating patients with residual or recurrent lesions with intraductal extension after EP treated with RFA. Case reports, duplicated data, and studies with follow-up periods &lt; 10 months were excluded. The metanalysis evaluated adverse events, surgical conversion rate, clinical success and recurrence.<\/jats:p><jats:p>\n            Results Seven studies were selected, totaling 124 patients. RFA was associated with a clinical success rate of 75.7% (95% confidence interval [CI] 65.0-88.0%; I2 = 23.484) in a mean follow-up period &lt; 10 months. However, the biliary stricture rate was 22.2% (95% CI 12.1-28.4%; I2 = 61.030), 14.3% of pancreatitis (95% CI 8.8-22.3%; I2 &lt; 0.001), 7.0% of cholangitis (95% CI 3.3-14.5%; I2 &lt; 0.001), 4.0% of bleeding (95% CI 1.7-9.3%; I2 &lt; 0.001), and recurrence of 24.3% (95% CI 16.0-35.0%; I2 = 23.484).<\/jats:p><jats:p>\n            Conclusions RFA is feasible and appears to be effective for managing residual or recurrent lesions with intraductal extension after EP. However, long-term follow-up and high-quality studies are required to confirm our findings.<\/jats:p>","DOI":"10.1055\/a-2226-0928","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:06:06Z","timestamp":1702339566000},"page":"E440-E447","source":"Crossref","is-referenced-by-count":9,"title":["Radiofrequency ablation for ampullary neoplasia with intraductal extension after endoscopic papillectomy: Systematic review and meta-analysis"],"prefix":"10.1055","volume":"12","author":[{"given":"Davi Lucena","family":"Landim","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7446-0355","authenticated-orcid":false,"given":"Diogo Turiani Hourneaux","family":"de Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0777-0150","authenticated-orcid":false,"given":"Bruno Salomao","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Henrique Peixoto","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus de Oliveira","family":"Veras","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Giacobo","family":"Nunes","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Ricardo Pavanatto","family":"Cavassola","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanderley Marques","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Guimar\u00e3es Hourneaux","family":"de Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1055\/a-1397-3198","article-title":"Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"53","author":"G Vanbiervliet","year":"2021","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.gie.2021.04.009","article-title":"Expert consensus on endoscopic papillectomy using a Delphi process","volume":"94","author":"JA Fritzsche","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/den.14233","article-title":"Clinical practice guidelines for endoscopic papillectomy","volume":"34","author":"T Itoi","year":"2022","journal-title":"Digest 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early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy?","volume":"66","author":"SM Yoon","year":"2007","journal-title":"Gastrointest Endosc"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/den.14681","article-title":"Safety and efficacy of endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine neoplasms: Systematic review and meta-analysis","author":"T Khoury","year":"2023","journal-title":"Digest Endosc"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"359","DOI":"10.3390\/medicina59020359","article-title":"Efficacy and safety of endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumors: a systematic review and metanalysis","volume":"59","author":"E Armellini","year":"2023","journal-title":"Medicina (B Aires)"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.gie.2017.10.029","article-title":"Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis","volume":"87","author":"AA Sofi","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.gie.2007.02.049","article-title":"Focal early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy?","volume":"66","author":"SM Yoon","year":"2007","journal-title":"Gastrointest Endosc"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14657","article-title":"The safety of newly developed automatic temperature-controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study","author":"YN Lee","year":"2019","journal-title":"J Gastroenterol Hepatol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1055\/a-1075-4080","article-title":"ERCP-related adverse events: European Society of Gastrointestinal 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