| Theme |
Advancement in Diagnosis and Treatment for Duodenal Neoplasms |
| Title |
Therapeutic Strategies for Non-ampullary Duodenal Tumors |
| Author |
Kosaku Moribata |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Mikitaka Iguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Yosuke Muraki |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Hisanobu Deguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Katsuya Takifuji |
Second Department of Surgery, Wakayama Medical University |
| Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
Non-ampullary duodenal tumors are rare in relation to gastrointestinal (GI) tumors. There is no consensus regarding strategies for treating these lesions. Endoscopic resection (ER) for lesions in the duodenum is useful, but requires a high level of skill.
We retrospectively verified the validity of the endoscopic submucosal dissection (ESD) procedures compared to endoscopic mucosal resection (EMR) for non-ampullary duodenal tumors. Our results indicated it was sufficient to resect tumors measuring less than 20 mm, except for the depressed type, with EMR. However, ESD procedures are effective for larger or depressed type tumors, which are difficult to snare, despite the longer procedure times and higher perforation rates. Endoscopic clip closure of post-ER ulcers is important to prevent delayed perforations and bleeding. |