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Endoscopy 2013; 45(02): 138-141
DOI: 10.1055/s-0032-1325799
Case report/series
© Georg Thieme Verlag KG Stuttgart · New York

Clinical outcomes of endoscopic resection for nonampullary duodenal high-grade dysplasia and intramucosal carcinoma

D. Maruoka
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
,
M. Arai
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
,
T. Kishimoto
3   Department of Molecular Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
,
T. Matsumura
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
,
M. Inoue
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
,
T. Nakagawa
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
,
Y. Watanabe
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
,
T. Katsuno
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
,
T. Tsuyuguchi
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
,
F. Imazeki
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
,
O. Yokosuka
1   Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
2   Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan
› Author Affiliations
Further Information

Publication History

submitted 14 February 2012

accepted after revision 27 August 2012

Publication Date:
15 January 2013 (online)

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This study retrospectively analyzed the clinical outcomes of endoscopic resection of 26 sporadic (i. e., not associated with polyposis syndrome) nonampullary duodenal lesions representing high-grade dysplasia or intramucosal carcinoma (duodenal HGD/IMC) in 23 patients. No severe complications such as perforation were observed, but three cases of delayed bleeding were seen. The use of endoscopic clips significantly decreased the delayed bleeding rate (0 /19, 0 %) compared with cases in which clips were not used (3 /7, 42.9 %; P = 0.013, χ2 test). Eighteen lesions (69.2 %) were removed by en bloc resection. The follow-up period after resection was 25.5 ± 23.3 months. Two lesions (7.7 %) that recurred locally were detected at the first surveillance endoscopy 3 months after resection. These lesions were 22 and 15 mm in size respectively and were resected piecemeal. Endoscopic resection is an effective and safe procedure for treating duodenal HGD/IMC. En bloc resection and prophylactic clip usage are encouraged.

 

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