Endoscopy 2023; 55(S 02): S301-S302
DOI: 10.1055/s-0043-1765836
Abstracts | ESGE Days 2023
ePoster

Duodenal endoscopic submucosal dissection: a safe alternative

E. Santos Pérez
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
F. Valentin Gomez
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
D. De Frutos Rosa
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
J. Santiago Garcia
2   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain, Majadahonda, Spain
,
P.D.C.A. M. Martins
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
G. M. Jimenez
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
L. Giménez Alvira
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
J. L. Lucena De La Poza
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
,
A. Herreros De Tejada Echanojauregui
1   Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain
› Author Affiliations
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Aims ESD for superficial duodenal epithelial tumors (SDETs) is still technically very challenging due to duodenal anatomy and high perforation and bleeding rate. For very large lesions (≥ 20 mm), ESD may be an option as it has a higher rate of en bloc resection than other ER[DdFR1] methods. However, its high adverse events (AE) rate limits its use.

The aim of our study was to evaluate the efficacy and security of ESD of SDETs.

Methods A case series through a prospective register of duodenal ESD performed from January 2018 to December 2021 in a tertiary referral hospital ([Fig. 1]).

Zoom Image
Fig. 1

Results A total of 8 patients underwent ESD to treat SDETs. 3 patients underwent ESD with laparoscopic assistance (laparoscopic and endoscopic cooperative surgery). The characteristics of the patients and general outcomes of the procedures are shown in Table 1. Technical success rate, en-bloc resection rate and R0 resection rate were 100%, 87.5% and 75% respectively. The median procedure time was 154 minutes. Intraprocedural perforation occurred in 3 patients (one patient required emergency surgery).. Intraprocedural bleeding occurred in 4 patients, solved endoscopically. There were no delayed perforation or bleeding [1] [2].

Conclusions ESD may be an option for large SDETs if performed by highly skilled endoscopists. Due to high adverse events rate, Duodenal ESD should be only considered in high volume center with an adequate collaboration with the Surgery Department.



Publication History

Article published online:
14 April 2023

© 2023. European Society of Gastrointestinal Endoscopy. All rights reserved.

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  • 1 Kato M, Takeuchi Y, Hoteya S, Oyama T, Nonaka S, Yoshimizu S, Kakushima N, Ohata K, Yamamoto H, Hara Y, Doyama H, Dohi O, Yamasaki Y, Ueyama H, Takimoto K, Kurahara K, Tashima T, Abe N, Nakayama A, Oda I, Yahagi N.. Outcomes of endoscopic resection for superficial duodenal tumors: 10 years' experience in 18 Japanese high volume centers. Endoscopy 2022; 54 (07) 663-670 DOI: 10.1055/a-1640-3236.. Epub 2021 Oct 28 PMID: 34496422
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Shibagaki K, Ishimura N, Kinoshita Y.. Endoscopic submucosal dissection for duodenal tumors. Ann Transl Med 2017; 5 (08) 188 DOI: 10.21037/atm.2017.03.63.. PMID: 28616403; PMCID: PMC5464942
    CrossrefPubMedGoogle Scholar