ENDOSCOPIC SUBMUCOSAL DISSECTION FOR DUODENAL SUBEPITHELIAL LESIONS: A CASE SERIES
Main Article Content
Abstract
Introduction: Duodenal subepithelial lesions are increasingly detected due to widespread screening endoscopy and imaging. Because duodenal surgery is invasive and carries substantial risk, endoscopic resection is preferred in selected cases.
Case series: We report five duodenal SELs treated with endoscopic submucosal dissection (ESD). En bloc resection was achieved in 4/5 cases, and R0 resection in 3/5. No bleeding or perforation occurred. All mucosal defects were prophylactically closed with clips. Ulcer healing was observed at 4 weeks.
Discussion: Pre-procedural evaluation with endoscopic ultrasonography is essential for treatment selection. Duodenal ESD enables en bloc resection but is technically demanding and associated with delayed adverse events; prophylactic closure may reduce complications.
Conclusion: In this case series, duodenal ESD appeared feasible and safe, providing good local control during 2–3 years of follow-up when performed by experienced endoscopists.
Keywords
Duodenal subepithelial lesion, Endoscopic Submucosal Dissection, Interventional endoscopy
Article Details
References
2. Yi K, Kim GH, Kim SJ, et al. Long-term outcomes of endoscopic resection for duodenal neuroendocrine tumors. Sci Rep. 2023;13(1):17908. Published 2023 Oct 20. doi:10.1038/s41598-023-45243-8
3. Uozumi T, Abe S, Makiguchi ME, et al. Complications of endoscopic resection in the upper gastrointestinal tract. Clin Endosc. 2023;56(4):409-422. doi:10.5946/ce.2023.024
4. Kato M, Ochiai Y, Fukuhara S, et al. Clinical impact of closure of the mucosal defect after duodenal endoscopic submucosal dissection. Gastrointest Endosc. 2019;89(1):87-93. doi:10.1016/j.gie.2018.07.026