# Balloon catheter‐assisted endoscopic resection for papillary adenoma of non‐exposed protruded type (with video)

## TL;DR

A new endoscopic technique using a balloon catheter was successfully used to resect a papillary adenoma with intraductal extension in an elderly patient.

## Contribution

The paper introduces a novel endoscopic technique using a balloon catheter to assist in the resection of non-exposed protruded papillary adenomas.

## Key findings

- The balloon catheter facilitated endoscopic visualization and resection of an intraductal papillary mass.
- Histopathology confirmed the resected tissue was a villous adenoma with high-grade dysplasia.
- Follow-up endoscopic ultrasound and biopsies were used to monitor for recurrence.

## Abstract

Papillary adenomas, known precursors to papillary adenocarcinoma, warrant close monitoring due to their malignant potential. Historically, surgical resection represented the mainstay of treatment for papillary adenomas with intraductal extension. However, recent advancements in endoscopic techniques have facilitated the adoption of endoscopic papillectomy as a minimally invasive alternative in carefully selected cases. We report a case of an 82‐year‐old woman with a diagnosis of papillary adenoma exhibiting intraductal extension. This was managed with a novel endoscopic technique, balloon catheter‐assisted endoscopic resection. Due to the obscured intraductal component of the papillary mass, a balloon occlusion catheter was deployed within the common bile duct and used as traction to facilitate endoscopic visualization of the mass. Endoscopic resection via papillectomy was subsequently performed. Histopathological examination of the resected specimen revealed a villous adenoma with high‐grade dysplasia. Serial endoscopic ultrasound examinations with targeted papillary biopsies were performed to monitor for disease recurrence.