ABSTRACT
Objective To assess the safety, efficacy and the clinical value of endoscopic treatment for duodenal lesions. Methods 59 patients with duodenal lesions were treated by endoscope from December 2012 to December 2016. The clinical data were retrospectively analyzed. Results There were 31 male and 28 female patients, aged 17 ～ 81 (58.2 ± 13.3) years. The lesion location included the duodenal bulb (n = 24, 40.68％) and the descending part (n = 21, 25.42％). The diameter of the lesions ranged from 0.2 to 5.0 (1.4 ± 0.9). Thirty-nine (66.10％) lesions originated from the mucosa, including inflammatory/hyperplastic polyps (n = 18, 30.51％), villous/tubular adenoma (n = 6, 10.17％). Twenty (33.90％) lesions originated from the submucosa, including Brunner's glands adenoma (n = 4, 6.78％), ectopic pancreas (n = 5, 8.47％), lipoma (n = 4, 6.78％). There were 4 delayed bleeding, 5 intraoperative perforation. Two patients received extended surgical resection later, and all the 59 patients showed no recurrence during the followed up (range, 3 ～ 30 months) using endoscopy. Conclusion Endoscopic treatment is a safe, effective, valuable method for the management of duodenal lesions.
ABSTRACT
Objective To assess the clinical value and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for duodenal lesions.Methods The data of 12 patients with duodenal space-occupying lesions underwent EMR or ESD from January 2010 to December 2015 in Chinese PLA General Hospital were retrospectively analysed.Results All patients received operation, including 9 male and 3 female with mean age of 50.0 years(33.0-62.0 years).There were 8 lesions in duodenal bulb and 4 in descending part.The mean diameter of the lesions was 1.2 cm (0.5-3.0 cm).Three lesions were originated from mucosa, of which 2 were high-grade intraepithelial neoplasia and 1 was villous/tubular adenoma.Nine lesions were located in submucosa, including 3 cases of neuroendocrine neoplasm, 1 case of stromal tumor, 1 liomyoma case, 1 lipoma case, 1 case of Brunner glands adenoma, 1 case of ectopic pancreas, and 1 inflammatory lesion.One patient had perforation with rate of 8.3%(1/12) and was recovered after conserved treatment.The bleeding was very little during operation.No infection or stenosis happened.The mean hospitalized time was 6.0 days (1.0-12.0 days) after operation.No recurrence was found during 23.8 months(3.0-73.0 months) of follow-up.Conclusion EMR and ESD are effective and safe for treatment of duodenal space-occupying lesions.