ASGE DDW Videos from Around the World | 2026-THROUGH-THE-SCOPE TACK AND SUTURE CLOSURE OF A LARGE AMPULLECTOMY DEFECT

THROUGH-THE-SCOPE TACK AND SUTURE CLOSURE OF A LARGE AMPULLECTOMY DEFECT

Video Transcription

Video Summary

A 62-year-old man underwent endoscopic ampullectomy for a large, spreading ampullary adenoma extending into the duodenum. After mucosal resection, pancreatic and biliary stents were placed. Standard through-the-scope clip closure was difficult with the duodenoscope elevator, so a through-the-scope TAC and suture device was used to approximate the defect and achieve hemostasis. Pathology showed adenoma with high-grade dysplasia. At one-month follow-up, there was no residual or recurrent adenoma. The case highlights TAC and suture closure as a useful minimally invasive option for large ampullary defects.

Asset Subtitle

Submitted by Jena Velji-Ibrahim

Keywords

endoscopic ampullectomy

ampullary adenoma

through-the-scope clip

TAC suture device

high-grade dysplasia