The role of endosonography in choosing the optimal method for removing adenomas of the major duodenal papilla

Aim. To evaluate the role of choice of endoscopic surgery in the treatment of patients with adenomas of the major duodenal papilla, using the developed endoscopic classification of adenomas based on duodenoscopy and endosonography. Material and methods. From 2000 to 2024, endoscopic removal of adenomas of the major duodenal papilla was performed in 200 patients. Endosonography was used at the diagnostic stage in 165 cases, while this diagnostic method was not used in 35 cases. Results. The technical success rate for endoscopic removal of adenomas of the major duodenal papilla was 100% in both groups. The postoperative complication rate was 16.9% in the study group, compared to 40% in the comparison group. In the long-term follow-up, adenoma recurrence rates were 6.6% in the study group and 20% in the comparison group. Conclusion. Personalized selection of the optimal surgical method for the removal of adenomas of the major duodenal papilla, depending on the classification typing of the neoplasm, allows for minimizing the risk of postoperative complications and increasing the radicality of the intervention.