GIANT AMPULLOMA, RESECTION WITH HOT SNARE POLLIPECTOMY AND CLOSING WITH SHORT STEM CLIP

A 59-year-old woman underwent a routine gastroscopy showed a 5 cm polypoid lesion in papillary area. Performed a piece-meal resection in 2 pieces and recovered for histological examination. Pancreatic duct cannulated and 5Fx7 cm plastic stent placed. Bile duct cannulated and common bile duct dilatation of 12 mm without pathologic content and placed a 10 Fx5 cm plastic stent, with spontaneous bile outflow. After resection 2 visible nonbleeding vessels, placing a short stem clip in one and 2 large stem clips in the other and injecting adrenalin. Long stem clips can unwittingly release when using the duodenoscope elevator system. 9 months follow-up without lesion recurrence.