An oblique-viewing endoscope was associated with a higher rate of en bloc resection during duodenal papillectomy, meaning removal in one piece, in a retrospective comparison. The approach was also reported to take longer, while adverse events and postoperative hospitalization did not differ significantly between the groups.
Two endoscopes, one retrospective review
The researchers retrospectively reviewed patients who underwent endoscopic papillectomy between February 2019 and August 2025, regardless of histopathological type. The cohort included 125 patients: 65 were treated with a forward-viewing endoscope, or FVE, and 60 with an oblique-viewing endoscope, or OVE. Baseline characteristics were reported as comparable.
The study compared the two endoscope types for both efficacy and safety. Its analysis included univariate and multivariate methods applied to demographic, procedure-related, adverse-event and follow-up data, as well as logistic regression to examine factors associated with piecemeal resection and adverse events.
Higher one-piece removal, longer procedures
The report said OVE-based papillectomy took longer. It lists the two group values as 21 and 39 minutes, with a reported p-value of 0.001. The available result does not identify which value belongs to which group, although it states that OVE was the longer procedure.
For en bloc resection, the OVE group had the higher reported rate: 80% compared with 61.5% for FVE. The reported p-value was 0.024. In this context, en bloc means the resection was completed in one piece.
That association remained after propensity score matching, a statistical approach used to make groups more comparable on measured characteristics. OVE was still associated with a higher en bloc resection rate, with the reported P value below 0.05.
Safety outcomes did not separate the groups
No statistically significant differences were reported for histopathology, postoperative hospitalization, adverse events or follow-up outcomes. The findings therefore point to an association between OVE and the higher one-piece resection rate, rather than showing that the endoscope itself caused the difference.
A separate logistic regression analysis identified submucosal injection as the only variable associated with piecemeal resection. That result is an association in retrospective data, not evidence that the injection caused the resection to be completed in pieces. No statistically significant factor was reported to be related to adverse events.
What the results leave unanswered
Because the study looked back at treatment records rather than assigning endoscope type prospectively, it cannot establish a causal effect. The available analysis does not provide detailed patient characteristics, the variables used for propensity matching, the matched sample or post-matching balance, detailed adverse-event counts, follow-up duration or adjusted effect estimates.
Patients were included regardless of histopathological type, creating possible clinical heterogeneity within the cohort. The study also does not establish that either endoscope is safer for a specific adverse event or that the observed association translates into better long-term patient outcomes.
Publication and disclosures
The article was published as a peer-reviewed original journal article. The article page reports acceptance on 5 August 2026 and publication, or version of record, on 21 August 2026.
Reported support came from the National Natural Science Foundation of China, the National Key R&D Program and Shanghai Municipal Science and Technology. All authors reported no conflicts of interest.
Study data were reported as available from the corresponding author upon reasonable request, but not publicly available because of privacy or ethical restrictions. The study reports adherence to the 1975 Declaration of Helsinki, ethics committee approval and informed consent for all procedures and interventions.
Paper data and sources
Original title: Forward- vs. Oblique-Viewing Endoscope for Duodenal Papillectomy: A Comparative Study on Efficacy and Safety.
Authors: Ke-Yi Guo, Xin Zhou, Yan Liu et al.
Journal/Repository: Digestive diseases and sciences
Status: Peer-reviewed
First online: 2026-08-21
DOI: 10.1007/s10620-026-10172-9
Original paper · Full text