The role of endoscopy in ampullary and duodenal adenomas

•Ampullary and duodenal adenomas have the potential for malignant transformation and require appropriate diagnostic evaluation. (1C)•Both ERCP and EUS are important tools in the evaluation and staging of ampullary adenomas and can assist in selecting candidates for endoscopic or surgical therapy. (1C)•Techniques of endoscopic removal of ampullary neoplasms are not standardized and should be performed by experienced endoscopists. (2C)•Patients undergoing endoscopic removal of ampullary and duodenal neoplasms should undergo postprocedure surveillance to ensure complete tissue removal and lack of disease recurrence. (2C)•Endoscopy is useful for evaluation and resection of sporadic duodenal adenomas using techniques similar to those used during polypectomy. (2C)•Patients with sporadic ampullary or duodenal adenomas are at increased risk for colon polyps and should be offered screening colonoscopy. (2C). © 2006 American Society for Gastrointestinal Endoscopy.