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Ampullary NeoplasmNCT07915726

Endoscopic Papillectomy Versus Surgery for Ampullary Tumors: A Prospective Multicenter Cohort Study

An observational study of Ampullary Neoplasm and Ampullary Adenoma, run by Qilu Hospital of Shandong University at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The aim of this study is to compare the efficacy and safety of endoscopic treatment (endoscopic papillectomy [EP] with or without intraductal radiofrequency ablation [RFA]) and surgical treatment (transduodenal ampullectomy [TSA] and pancreatoduodenectomy [PD]) in patients with ampullary tumors (ampullary adenoma and… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Ampullary Neoplasm, Ampullary Adenoma
What is being tested?
Endoscopic treatment group and Surgical treatment group
Type of treatment
Surgery or procedure
How many people
306 participants
Where
1 siteChina
Study dates
20 Oct 2026to 20 Oct 2036
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients with histologically confirmed ampullary adenoma or early ampullary carcinoma (Tis/T1) without invasion into the duodenal muscularis propria, staged M0/N0 by EUS , MRCP and CT , with intraductal tumor extension ≤ 20 mm on EUS, MRCP, or IDUS, undergoing endoscopic papillectomy or surgery.

Who may be able to join

  • Patients aged ≥18 years
  • Patients with histologically confirmed ampullary adenoma or early ampullary carcinoma (Tis/T1) based on endoscopic biopsy (i.e., without tumor invasion into the duodenal muscularis propria).
  • Preoperative staging by endoscopic ultrasound (EUS) , magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT) showing no distant metastasis (M0) and no lymph node metastasis (N0).
  • Intraductal tumor extension (ITE) ≤ 20 mm assessed by EUS, MRCP or Intraductal ultrasound (IDUS ).
  • Planned to undergo EP, with or without intraductal RFA, or surgical treatment (TSA or PD).
  • Patients who provide written informed consent.

Who cannot join

  • Patients unable to tolerate general anesthesia or surgery.
  • Ectopic duodenal papilla.
  • Contraindications to endoscopic procedures (e.g., severe esophageal stenosis, gastric outlet obstruction, or other conditions precluding endoscopic access to the papilla).
  • Major upper abdominal surgery or previous biliary surgery history.
  • Uncorrectable coagulopathy (INR > 1.5) or thrombocytopenia (platelet count < 50,000/μL), or inability to withhold antithrombotic (anticoagulant or antiplatelet) therapy for the planned endoscopic or surgical procedure..
  • Pregnant or lactating women.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site
  • Qilu Hospital of Shandong University

    Jinan, Shandong, 250012

    Zhen Li, 18560086106, qilulizhen@sdu.edu.cn

Other trials in China

About this study

Official title: Investigation of the Indications and Clinical Outcomes of Endoscopic Papillectomy Versus Surgery for Ampullary Tumors

The aim of this study is to compare the efficacy and safety of endoscopic treatment (endoscopic papillectomy [EP] with or without intraductal radiofrequency ablation [RFA]) and surgical treatment (transduodenal ampullectomy [TSA] and pancreatoduodenectomy [PD]) in patients with ampullary tumors (ampullary adenoma and early ampullary carcinoma), focusing on residual disease, recurrence, postoperative complications, and overall costs.

Read the detailed description

This is a multicenter, two-arm, prospective cohort study. The diagnosis of ampullary adenoma must be confirmed by biopsy.

The endoscopic treatment group receives EP; patients without intraductal extension receive EP alone, while patients with intraductal extension receive additional RFA in the same or a subsequent session. The surgical treatment group receives TSA or PD. Patients are followed up at 3, 6, and 12 months after the initial treatment, then annually for at least 5 years, with side-viewing duodenoscopy, targeted biopsy, and CT assessment. To control confounding between the two groups, propensity score matching and inverse probability of treatment weighting will be applied.

Being tested
Endoscopic treatment group, Surgical treatment group
Keywords
endoscopic papillectomy, ampullary adenoma, intraductal radiofrequency ablation, transduodenal ampullectomy, pancreaticoduodenectomy, ampullary carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Endoscopic treatment groupProcedure or surgery

    Endoscopic papillectomy (EP); EP combined with intraductal RFA for lesions with intraductal tumor extension.

  • Surgical treatment groupProcedure or surgery

    TSA or PD

Study groups in NCT07915726
Study groupRoleWhat they receive
Endoscopic treatment groupPatients undergoing EP with or without RFA.
Receives: Procedure: Endoscopic treatment group
Surgical treatment groupPatients undergoing surgical treatment.
Receives: Procedure: Surgical treatment group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recurrence rate at 12 months

    Recurrence confirmed by endoscopic biopsy after an interval ≥ 3 months from the end of treatment, assessed at the 12-month follow-up.

    Measured: At 12 months after the initial treatment

Secondary outcomes (16)
  1. R0 resection rate

    Proportion of patients with complete resection achieved at the first endoscopic or surgical intervention and confirmed by histology (negative margins).

    Measured: Periprocedural

  2. Procedure-related adverse event rate

    Proportion of patients who experienced at least one adverse event attributable to the initial endoscopic or surgical procedure within 30 days after the procedure, irrespective of severity.

    Measured: Up to 90 days after the initial treatment

  3. Recurrence rate at 6 months

    Recurrence confirmed by endoscopic biopsy after an interval ≥ 3 months from the end of treatment, assessed at the 6-month follow-up.

    Measured: At 6 months after the initial treatment

  4. Residual lesion rate

    Presence of residual adenoma tissue at the next endoscopy after treatment.

    Measured: Up to 3 months after the initial treatment

  5. Clinical success rate

    Proportion of patients who achieved complete excision of the lesion (regardless of the number of procedures) with no histologically confirmed adenoma regrowth, no evidence of invasive cancer, and without the need for surgical resection, during follow-up up to 5 years after the initial treatment.

    Measured: Up to 5 years after the initial treatment

  6. Endoscopic treatment failure rate

    Inability to completely resect the lesion endoscopically (regardless of the number of procedures), histopathologically invasive malignancy, or recurrence no longer amenable to endoscopic treatment.

    Measured: Up to 12 months after the initial treatment

  7. Total number of readmissions within 12 months

    All readmissions due to disease-related symptoms (e.g., cholangitis, pancreatitis, obstructive jaundice) or treatment-related events (e.g., bleeding, perforation, anastomotic problems).

    Measured: Up to 12 months after the initial treatment

  8. Technical success rate

    Proportion of patients in whom the planned procedure was completed as intended.

    Measured: Periprocedural

  9. Total treatment cost

    All direct medical costs from admission to 12 months after the initial treatment (including procedure, anesthesia, hospitalization, medication, examinations, and readmission costs).

    Measured: Up to 12 months after the initial treatment

  10. Index hospitalization length of stay

    Number of calendar days from the date of admission for the initial treatment to the date of discharge for the initial treatment,including the day of admission

    Measured: Periprocedural

  11. Total length of stay within 12 months

    Total number of calendar days spent in hospital within 12 months after the initial treatment, including the index hospitalization and all readmissions due to disease-related symptoms or treatment-related events.

    Measured: Up to 12 months after the initial treatment

  12. Postprocedural pancreatitis rate

    Defined by two of three criteria: characteristic abdominal pain; amylase or lipase > 3× upper limit of normal; imaging features of pancreatitis; severity graded mild / moderate / severe per protocol.

    Measured: Up to 90 days after the initial treatment

  13. Postprocedural bleeding rate

    Proportion of patients with clinically significant post-procedural bleeding within 30 days after the procedure, defined as any of the following after achieving primary haemostasis: overt bleeding symptoms (hematemesis, melena, hematochezia, or blood aspirated via nasogastric tube); haemodynamic instability attributable to bleeding; a decrease in haemoglobin greater than 2 g/dL; or direct endoscopic evidence of bleeding from the papillectomy site.

    Measured: Up to 90 days after the initial treatment

  14. Postprocedural perforation rate

    Direct visualization of a transmural defect during endoscopy, or radiographic evidence of extraluminal free air on abdominal CT or plain radiograph.

    Measured: Up to 90 days after the initial treatment

  15. Postprocedural cholangitis rate

    New onset temperature >38 °C for more than 24 hours combined with cholestasis. Severity will be graded separately according to the TG18 severity classification (Grade I / II / III) and reported descriptively.

    Measured: Up to 90 days after the initial treatment

  16. Cumulative recurrence rate

    Cumulative recurrence during annual follow-up up to 5 years

    Measured: Through study completion, an average of 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Nov 2026
  2. Study start20 Oct 2026 (estimated)
  3. Primary completion20 Oct 2032 (estimated)
  4. Study completion20 Oct 2036 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
306 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07915726
Sponsor's protocol ID
2026SDU-QILU-6
Status last verified
Oct 2026
First submitted
18 Oct 2026
Last updated
4 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Cotton PB, Eisen GM, Aabakken L, Baron TH, Hutter MM, Jacobson BC, Mergener K, Nemcek A Jr, Petersen BT, Petrini JL, Pike IM, Rabeneck L, Romagnuolo J, Vargo JJ. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010 Mar;71(3):446-54. doi: 10.1016/j.gie.2009.10.027. No abstract available.

    PubMed 20189503
  • Kiriyama S, Kozaka K, Takada T, Strasberg SM, Pitt HA, Gabata T, Hata J, Liau KH, Miura F, Horiguchi A, Liu KH, Su CH, Wada K, Jagannath P, Itoi T, Gouma DJ, Mori Y, Mukai S, Gimenez ME, Huang WS, Kim MH, Okamoto K, Belli G, Dervenis C, Chan ACW, Lau WY, Endo I, Gomi H, Yoshida M, Mayumi T, Baron TH, de Santibanes E, Teoh AYB, Hwang TL, Ker CG, Chen MF, Han HS, Yoon YS, Choi IS, Yoon DS, Higuchi R, Kitano S, Inomata M, Deziel DJ, Jonas E, Hirata K, Sumiyama Y, Inui K, Yamamoto M. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17-30. doi: 10.1002/jhbp.512. Epub 2018 Jan 5.

    PubMed 29032610
  • Abraham NS, Barkun AN, Sauer BG, Douketis J, Laine L, Noseworthy PA, Telford JJ, Leontiadis GI. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period. Am J Gastroenterol. 2022 Apr 1;117(4):542-558. doi: 10.14309/ajg.0000000000001627.

    PubMed 35297395
  • Karam E, Hollenbach M, Ali EA, Auriemma F, Gulla A, Heise C, Regner S, Gaujoux S; on the Pancreas 2000 Research Group; Regimbeau JM, Kahler G, Seyfried S, Vaillant JC, De Ponthaud C, Sauvanet A, Birnbaum D, Regenet N, Truant S, Perez-Cuadrado-Robles E, Bruzzi M, Lupinacci RM, Brunel M, Belfiori G, Barbier L, Salame E, Souche FR, Schwarz L, Maggino L, Salvia R, Gagniere J, Del Chiaro M, Leung G, Hackert T, Kleemann T, Paik WH, Caca K, Dugic A, Muehldorfer S, Schumacher B, Albers D. Outcomes of rescue procedures in the management of locally recurrent ampullary tumors: A Pancreas 2000/EPC study. Surgery. 2023 May;173(5):1254-1262. doi: 10.1016/j.surg.2022.12.011. Epub 2023 Jan 13.

    PubMed 36642655
  • Fritzsche JA, Fockens P, Barthet M, Bruno MJ, Carr-Locke DL, Costamagna G, Cote GA, Deprez PH, Giovannini M, Haber GB, Hawes RH, Hyun JJ, Itoi T, Iwasaki E, Kylanpaa L, Neuhaus H, Park JY, Reddy DN, Sakai A, Bourke MJ, Voermans RP. Expert consensus on endoscopic papillectomy using a Delphi process. Gastrointest Endosc. 2021 Oct;94(4):760-773.e18. doi: 10.1016/j.gie.2021.04.009. Epub 2021 Apr 19.

    PubMed 33887269
  • Vanbiervliet G, Strijker M, Arvanitakis M, Aelvoet A, Arnelo U, Beyna T, Busch O, Deprez PH, Kunovsky L, Larghi A, Manes G, Moss A, Napoleon B, Nayar M, Perez-Cuadrado-Robles E, Seewald S, Barthet M, van Hooft JE. Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2021 Apr;53(4):429-448. doi: 10.1055/a-1397-3198. Epub 2021 Mar 16.

    PubMed 33728632
  • Abe S, Sakai A, Masuda A, Miki M, Harada Y, Nagao K, Inomata N, Kohashi S, Uemura H, Masuda S, Ashina S, Gonda M, Yamakawa K, Tsujimae M, Yamada Y, Tanaka T, Kobayashi T, Nakano R, Shiomi H, Tsugawa D, Yanagimoto H, Ajiki T, Kanzawa M, Fukumoto T, Itoh T, Kodama Y. Advantage of endoscopic papillectomy for ampullary tumors as an alternative treatment for pancreatoduodenectomy. Sci Rep. 2022 Sep 7;12(1):15134. doi: 10.1038/s41598-022-19439-3.

    PubMed 36071180
  • Hollenbach M, Heise C, Abou-Ali E, Gulla A, Auriemma F, Soares K, Leung G, Schattner MA, Jarnagin WR, Wang T, Caillol F, Giovannini M, Dahel Y, Hackert T, Paik WH, Zerbi A, Nappo G, Napoleon B, Arnelo U, Haraldsson E, Halimi A, Waldthaler A, Will U, Saadeh R, Masaryk V, van der Wiel SE, Bruno MJ, Perez-Cuadrado-Robles E, Deprez P, Sauvanet A, Bolm L, Keck T, Souche R, Fabre JM, Musquer N, Kahler G, Seyfried S, Petrone MC, Mariani A, Zaccari P, Belfiori G, Crippa S, Falconi M, Partelli S, Yilmaz B, Demir IE, Ceyhan GO, Satoi S, Regimbeau JM, Gagniere J, Repici A, Anderloni A, Vollmer C, Casciani F, Del Chiaro M, Oba A, Schulick RD, Berger A, Maggino L, Salvia R, Schemmer P, Wichmann D, Inoue Y, Dinis-Ribeiro M, Laranjo A, Libanio D, Kleemann T, Sandru V, Ilie M, Ahola R, Laukkarinen J, Schumacher B, Albers D, Curdia Goncalves T, Barbier L, Salame E, Weismuller TJ, Heling D, Alves A, Karam E, Regenet N, Dugic A, Muehldorfer S, Truant S, Caca K, Meier B, Miutescu BP, Tantau M, Birnbaum D, Miksch RC, Wedi E, Salzmann K, Bruzzi M, Lupinacci RM, David P, De Ponthaud C, Schmidt A, Regner S, Gaujoux S; ESAP study group. Endoscopic papillectomy versus surgical ampullectomy for adenomas and early cancers of the papilla: a retrospective Pancreas2000/European Pancreatic Club analysis. Gut. 2025 Feb 6;74(3):397-409. doi: 10.1136/gutjnl-2022-327996.

    PubMed 39642968

Questions about this trial

What is this clinical trial studying?

An observational study of Ampullary Neoplasm and Ampullary Adenoma, run by Qilu Hospital of Shandong University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Zhen Li, MD (18560086106, qilulizhen@sdu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recurrence rate at 12 months (time frame: At 12 months after the initial treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07915726, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2026.

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