Evaluating the outcomes and safety of underwater ampullectomy versus traditional (gas insufflation) ampullectomy (with video).

Publication/Presentation Date

1-1-2026

Abstract

BACKGROUND AND AIMS: Underwater endoscopic mucosal resection has shown promise in colorectal and nonampullary duodenal polyps but remains understudied in ampullary lesions. This study aimed to compare underwater ampullectomy (UA) and traditional gas-insufflation ampullectomy (TA), hypothesizing UA would have improved en bloc resection rates confirmed with negative histologic margins and have shorter procedure times, with similar adverse events.

METHODS: A retrospective cohort analysis was conducted for patients undergoing endoscopic ampullectomy (UA vs TA) from September 2020 to April 2023. Primary outcome was negative margin rates on histopathology; secondary outcomes included procedure duration, adverse events (AEs), and recurrence/residual adenoma rate.

RESULTS: Of 37 patients (UA 11, TA 26), UA achieved significantly greater negative margin rates on histopathology than TA (72.7% vs 30.8%; P = .03). Procedure duration was numerically shorter for UA (66.8 minutes vs 82.5 minutes) and recurrence/residual adenoma rate was numerically lower in UA (15.4% vs 18.2%) compared with TA without reaching statistical significance. AE rate was not significantly different (UA 45% vs TA 42.3%, P = 1.00) between the 2 groups.

CONCLUSIONS: UA demonstrates significantly greater rates of en bloc resections with negative histopathologic margins compared with TA, with similar rates of AEs.

Volume

103

Issue

1

First Page

162

Last Page

166

ISSN

1097-6779

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40592413

Department(s)

Administration and Leadership

Document Type

Article

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