PTU-064 Endoscopic resection of non-ampullary duodenal lesions: feasibility, safety and efficacy

Queen Alexandra Hospital, PortsmouthIntroductionNon-ampullary duodenal adenomas (sporadic and duodenal lesions associated with familial adenomatous polyposis or FAP) are rare, with most lesions found incidentally on gastroscopy.Endoscopic resection of duodenal lesions is increasingly being used in place of invasive surgery. However, endoscopic resection in the duodenum can be challenging due to its anatomy and may be associated with a higher risk of complications. This study aims to evaluate the safety and efficacy of endoscopic resection of duodenal polyps.MethodsAll patients with large (>10 mm) non-ampullary duodenal polyps who underwent endoscopic resection between February 2008 and January 2019 in a single tertiary referral centre were included in the study. A retrospective analysis on data including demographics, size, histology, location, method of resection and complications was performed.ResultsThere were a total of 85 patients with polyps >10 mm referred for endoscopic therapy (median age 64 years, [IQR] 27–87 years, 52% male). 58 (68%) underwent endoscopic mucosal resection (EMR) and 27 (32%) had knife assisted resection (KAR). Histology revealed 67 (79%) LGD and 11 (13%) HGD. Majority of the lesions (70) were found in D2 (82%). 8 patients (9.4%) had a diagnosis of FAP.The mean polyp size was 25.3 mm [IQR 10–80]. 80 polyps (94.1%) were removed in a single session with an en-bloc resection rate of 40%. The overall recurrence, bleeding and perforation rate was 7%, 8% and 2% respectively.Table 1 shows the complication and recurrence rates stratified by lesion size (30 mm).Abstract PTU-064 Table 1 Lesion size 30 mm P value Number 53 32 Bleeding 2 (4%) 5 (15%) p =