Evidence map›Paper›PMID 40854993›Full record

ArticleSurgical endoscopy2025

Comparison of endoscopic papillectomy and pancreatoduodenectomy for high-grade intraepithelial neoplasia of the duodenal papilla: a retrospective cohort study.

Yuan Chen, Zhengwang Wang, Yuanyuan Chen, Ke Zhang, Xinyu Ge, Jie Zhu, Peng Wang, Qingcheng Xu, Denghao Deng, Jun Liu and 5 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Endoscopic Papillectomy for Ampullary Tumors in Older Patients: Balancing Oncologic Benefit and Geriatric Risk.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Yuan Chen *Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Zhengwang Wang *Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Yuanyuan Chen *Changzhou Hygiene Vocational Technology College, Changzhou, China.
Ke ZhangDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Xinyu GeDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Jie ZhuDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Peng WangDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Qingcheng XuDepartment of Hepatobiliary and Pancreatic Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Denghao DengDepartment of Hepatobiliary and Pancreatic Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Jun LiuDepartment of Hepatobiliary and Pancreatic Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Xiaolan XuDepartment of Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Juan ChenDepartment of Hepatobiliary and Pancreatic Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Dousheng BaiDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Peng XuDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China. pengxu1986@126.com.
Jie YaoDepartment of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China. dryaojie@yzu.edu.cn.ORCID http://orcid.org/0000-0001-5447-893X

Funding

Innovative Research Group Project of the National Natural Science Foundation of China 81772516
6 · The paper itself

Abstract

aimThe objective of this study is to compare the clinical outcomes of endoscopic papillectomy (EP) and pancreatoduodenectomy (PD) for high-grade intraepithelial neoplasia of the duodenal papilla (HGIN-DP) and develop a preoperative risk prediction model for pathological upgrading.

methodsRetrospective analysis of 92 patients (43 EP vs. 49 PD) treated between 2014 and 2023. Propensity score matching (1:1) balanced baseline characteristics, yielding 62 matched cases. Univariate and multivariate logistic regression analysis identified risk factors for pathological upgrading. A nomogram was developed and validated using patient data.

resultsPD demonstrated superior 5-year overall survival (88.5% vs. 61.2%, P < 0.05) but longer operative time (230.0 vs. 41.0 min), higher blood loss (250.0 vs. 1.0 mL), prolonged hospitalization (27.0 vs. 8.0 days), increased costs (CNY 71,116.0 vs. 25,898.0), and higher delayed gastric emptying rates (35.5% vs. 3.2%) compared to EP. Postoperative pathological upgrading occurred in 51.2% (EP) and 69.4% (PD) of cases. Among them, 29.0% were diagnosed with adenocarcinoma in the EP group and 38.7% in the PD group. Multivariate analysis identified age (OR = 1.11), platelet count (OR = 1.02), and tumor size > 1 cm (OR = 21.79) as risk factors for pathological upgrading. A nomogram incorporating these predictors showed strong discriminative accuracy (AUC = 0.91 training, 0.86 validation).

conclusionEP offers advantages in recovery and cost, while PD remains preferable for HGIN-DP patients with high-risk features. The validated prediction model aids preoperative risk stratification, guiding personalized treatment decisions.

Indexed as

Ampulla of VaterCarcinoma in SituCommon Bile Duct NeoplasmsPancreaticoduodenectomySphincterotomy, EndoscopicAgedFemaleHumansMaleMiddle AgedNomogramsPropensity ScoreRetrospective StudiesTreatment OutcomeDuodenal papillaEndoscopic papillectomyHigh-grade intraepithelial neoplasiaPancreatoduodenectomyPrediction model

Identifiers

PMID40854993

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.