Clinical characteristics, endoscopic management, and long-term outcomes of ectopic papilla of vater in the duodenal bulb: a retrospective analysis of 18 cases

This study aims to evaluate the clinical features, efficacy of endoscopic therapy, and long-term prognosis in patients with ectopic papilla of Vater (EPV) located in the duodenal bulb. A retrospective review was conducted on 18 patients diagnosed with EPV between 2010 and 2024. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Treatment outcomes, procedural success, complications, and recurrence rates during follow-up were analyzed. The cohort consisted of 15 males and 3 females, with a mean age of 56.2 ± 21.3 years. Common presentations included abdominal pain (100%), fever (61%), and jaundice (33%). Eleven patients had a history of cholecystectomy. Endoscopic intervention was successful in 17 patients (94.4%), with two requiring subsequent surgical management due to unsuccessful stone extraction. During a median follow-up of 24 months, recurrence of biliary stones, cholangitis, or pancreatitis was observed in 10 of the 14 followed-up patients (71.4%). Endoscopic therapy is effective for the initial management of EPV in the duodenal bulb. However, due to high recurrence rates of biliary and pancreatic complications, long-term monitoring and individualized treatment strategies are essential.