言語種別	英語
発表タイトル	Evaluation of the Feasibility and Utility of DLECS for Superficial Ampullary Epithelial Tumors
会議名	JDDW 2026 KOBE 第34回日本消化器関連学会週間
学会区分	全国規模の学会
発表形式	口頭
講演区分	シンポジウム・ワークショップ パネル（公募）
発表者・共同発表者	◎高橋悠，　井上健太郎，　長沼誠
発表年月日	2026/11/06
開催地 （都市, 国名）	神戸コンベンションセンター
概要	(Background) Pancreaticoduodenectomy is the standard treatment for ampullary carcinoma. Endoscopic papillectomy is widely accepted for ampullary adenomas smaller than 10 mm; however, optimal management of larger lesions remains controversial. Endoscopic resection alone carries risks of incomplete resection and perforation, while surgical papilloplasty is more invasive. To address these limitations, we introduced duodenal laparoscopic and endoscopic cooperative surgery (DLECS) as a minimally invasive alternative for ampullary tumors. (Methods) We retrospectively analyzed 12 patients with ampullary adenomas larger than 10 mm treated between 2018 and 2025. Patients were divided into a DLECS group (n=5) and a surgical papilloplasty (SP) group (n=7). Perioperative and oncological outcomes were compared. (Results) Median tumor size was 22 mm (10-35) in the DLECS group and 15 mm (10-20) in the SP group. No postoperative complications occurred in the DLECS group, whereas 2 patients (29%) in the SP group developed intra-abdominal infections. Peak postoperative laboratory values (amylase, total bilirubin, AST, ALT, CRP) were similar between groups. Median hospital stay was 12 days (12-16) for DLECS and 15 days (11-58) for SP. R0 resection was achieved in all cases, with no recurrence observed. (Conclusions) DLECS appears to be a feasible, minimally invasive option with comparable oncological outcomes and fewer complications than SP for larger ampullary adenomas.We will present and demonstrate videos of the techniques.