Feasibility of endoscopic submucosal dissection including papilla (with video)

Endoscopic papillectomy (EP) is a low-invasive treatment for duodenal tumors including papilla. The limit of lesion size and local recurrence have been issues in EP. We developed endoscopic submucosal dissection (ESD) for the duodenal tumors including papilla (ESDIP: ESD including papilla) to overco...

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Hauptverfasser: Yahagi, Naohisa, Takatori, Yusaku, Sasaki, Motoki, Imura, Yuri, Murata, Shoma, Sato, Tsubasa, Minezaki, Daisuke, Hayakawa, Takaoki, Nakajima, Yuki, Okada, Haruka, Sakurai, Hinako, Tojo, Anna, Iwata, Kentaro, Miyazaki, Kurato, Kayashima, Atsuto, Masunaga, Teppei, Mizutani, Mari, Akimoto, Teppei, Seino, Takashi, Kawasaki, Shintaro, Horibe, Masayasu, Fukuhara, Seichiro, Matsuura, Noriko, Sujino, Tomohisa, Nakayama, Atsushi, Takabayashi, Kaoru, Iwasaki, Eisuke, Kato, Motohiko
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container_title Digestive endoscopy
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creator Yahagi, Naohisa
Takatori, Yusaku
Sasaki, Motoki
Imura, Yuri
Murata, Shoma
Sato, Tsubasa
Minezaki, Daisuke
Hayakawa, Takaoki
Nakajima, Yuki
Okada, Haruka
Sakurai, Hinako
Tojo, Anna
Iwata, Kentaro
Miyazaki, Kurato
Kayashima, Atsuto
Masunaga, Teppei
Mizutani, Mari
Akimoto, Teppei
Seino, Takashi
Kawasaki, Shintaro
Horibe, Masayasu
Fukuhara, Seichiro
Matsuura, Noriko
Sujino, Tomohisa
Nakayama, Atsushi
Takabayashi, Kaoru
Iwasaki, Eisuke
Kato, Motohiko
description Endoscopic papillectomy (EP) is a low-invasive treatment for duodenal tumors including papilla. The limit of lesion size and local recurrence have been issues in EP. We developed endoscopic submucosal dissection (ESD) for the duodenal tumors including papilla (ESDIP: ESD including papilla) to overcome the problems. The aim of this study was to evaluate the feasibility of ESDIP. We included the patients who underwent ESDIP from August 2010 to January 2024 in this study. We evaluated the retrospective characteristics of patients and lesions, clinical results of ESDIP and of endoscopic retrograde cholangiopancreatography (ERCP) as prevention for delayed adverse events, and pathological findings. We also calculated the cumulative recurrence rate and overall survival rate at 12 months after ESDIP. Fifty-four patients were included in this study. The mean lesion size was 39 mm. The third-quarter cases revealed a less than half-circumferential lesion, and the one case with a full-circumferential lesion. Resection was accomplished in 96% (n = 52), and also the en-bloc resection rate was 96%. Of the cases in accomplished resection, 98% of patients were intubated with a pancreaticobiliary drainage tube by ERCP. Intraprocedural perforation occurred in eight cases. Delayed bleeding occurred in 10 cases. Delayed perforation was seen only in one case. The incidence of post-ERCP pancreatitis was 25%. Cumulative local recurrence rate and the overall survival rate were 15% and 96%, respectively. ESDIP may be feasible for duodenal tumors including papilla, and is a potential alternative option to avoid pancreaticoduodenectomy.
doi_str_mv 10.1111/den.14942
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The limit of lesion size and local recurrence have been issues in EP. We developed endoscopic submucosal dissection (ESD) for the duodenal tumors including papilla (ESDIP: ESD including papilla) to overcome the problems. The aim of this study was to evaluate the feasibility of ESDIP. We included the patients who underwent ESDIP from August 2010 to January 2024 in this study. We evaluated the retrospective characteristics of patients and lesions, clinical results of ESDIP and of endoscopic retrograde cholangiopancreatography (ERCP) as prevention for delayed adverse events, and pathological findings. We also calculated the cumulative recurrence rate and overall survival rate at 12 months after ESDIP. Fifty-four patients were included in this study. The mean lesion size was 39 mm. The third-quarter cases revealed a less than half-circumferential lesion, and the one case with a full-circumferential lesion. Resection was accomplished in 96% (n = 52), and also the en-bloc resection rate was 96%. Of the cases in accomplished resection, 98% of patients were intubated with a pancreaticobiliary drainage tube by ERCP. Intraprocedural perforation occurred in eight cases. Delayed bleeding occurred in 10 cases. Delayed perforation was seen only in one case. The incidence of post-ERCP pancreatitis was 25%. Cumulative local recurrence rate and the overall survival rate were 15% and 96%, respectively. 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title Feasibility of endoscopic submucosal dissection including papilla (with video)
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