Safety of endoscopic resection for duodenal subepithelial lesions with wound closure using clips and an endoloop: an analysis of 68 cases

Ye, Liping; Mao, Xin-Li; Zheng, Haihong; Yu, Zhang; Shen, Lingyan; Zhou, Xian-Bin; Zhu, Lin-Hong

doi:10.1007/s00464-016-5065-9

Cited by 21 publications

(20 citation statements)

References 23 publications

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“…Clips have been used to close Stapfer type I perforations in the majority of cases ( Table 8 s). For large perforations, a combination of an endoloop and TTS clips can enable successful closure [149,190], although TTS clips alone may be sufficient [189,192]. Recently, OTS clips have been used for perforations of up to 20 mm in diameter, using two clips in some cases [193 -199].…”

Section: Techniques For Endoscopic Closurementioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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Summary of Recommendations 1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforations, including the definition of procedures that carry a higher risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 ESGE recommends that in the case of an endoscopically identified perforation, the endoscopist reports its size and location, with an image, and statement of the endoscopic treatment that has been applied. 3 ESGE recommends that symptoms or signs suggestive of iatrogenic perforation after an endoscopic procedure should be rapidly and carefully evaluated and documented with a computed tomography (CT) scan. 4 ESGE recommends that endoscopic closure should be considered depending on the type of the iatrogenic perforation, its size, and the endoscopist expertise available at the center. Switch to carbon dioxide (CO2) endoscopic insufflation, diversion of digestive luminal content, and decompression of tension pneumoperitoneum or pneumothorax should also be performed. 5 ESGE recommends that after endoscopic closure of an iatrogenic perforation, further management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of an iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical consultation are recommended.

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Section: Techniques For Endoscopic Closurementioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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“…10 The lesions in this study were also pathologically homogenous compared to previous reports, which included various submucosal lesions. 17 The outcomes of mucosal closure after ER between lesions originating from the submucosal and mucosal layers may differ since the depth of the mucosal defect after ER is different.…”

Section: Discussionmentioning

confidence: 99%

“…In cases of failure, endoscopic clipping might cause perforation or bleeding since the duodenal wall is relatively thin. 15,17 In addition, complete closure of a large mucosal defect after ER for SNADT is sometimes difficult. 14,16 Fortunately in this study, endoscopic clipping was successfully performed without complications in every case; this was mainly due to relatively small size of the lesions in this study.…”

Section: Discussionmentioning

confidence: 99%

The Use of Endoscopic Clipping in Preventing Delayed Complications after Endoscopic Resection for Superficial Non-Ampullary Duodenal Tumors

Kim

et al. 2021

Clin Endosc

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Superficial non-ampullary duodenal tumors (SNADTs) are defined as adenomas or adenocarcinomas in the duodenum that did not originate from the ampulla of Vater and are limited to the mucosal/submucosal layer. 1,2 The incidence of SNADT among patients who underwent duodenoscopy is 0.03% to 0.4%. 3 Although primary duodenal carcinomas are rare, the prognosis of advanced duodenal carcinomas is very poor. 4 Thus, early detection and treatment is crucial. Although the standard therapy for SNADT has yet to be established, endoscopic resection (ER) has shown to be beneficial for patients with SNADT. 5-8 When mucosal defects occur after ER, pancreatic juice and bile acid may act as offensive agents and cause complications like delayed bleeding and delayed perforation. 9,10 According to a previous report, the incidence of delayed perforations after ER for SNADT is 6.3%. 11 To prevent these complications, prophylactic procedures, such application of glycolic acid sheets, coagulation of visible vessels, and endoscopic clipping, have been introduced. 12-18 However, previous reports on these procedures had several limitations: most of the studies were performed in single centers and heterogenous disease entities were included. Because of this, the prophylactic effects of endoscopic clipping have not been well-established. This study aimed to investigate the effects of prophylactic clipping

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“…Fewer than 30 cases of duodenal lipomas with active GI bleeding have been reported. 4 Moreover, only a few reports of successful ER of duodenal lipomas with bleeding have been published. [5][6][7][8][9][10][11] We summarized a review of the literature on duodenal lipomas with GI bleeding (Table 1).…”

Section: Discussionmentioning

confidence: 99%

A Case of a Bleeding Duodenal Lipoma Successfully Controlled by Endoscopic Resection

Gwak¹,

Lee²,

Lee³

2020

Clin Endosc

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This is a case report of successful endoscopic resection (ER) of a bleeding duodenal lipoma. An 85-year-old woman who was diagnosed with asymptomatic subepithelial tumor of the duodenum 3 years ago visited the emergency room with hematemesis and was admitted to our hospital. Emergent esophagogastroduodenoscopy revealed bleeding from an ulcer on the superior aspect of a subepithelial tumor measuring about 20 mm in diameter, at the superior duodenal angle. The ulcer was in the active stage (A1), with a visible vessel. The bleeding was controlled by ER of the tumor using a snare. The final pathological diagnosis was duodenal lipoma with mucosal ulceration. The patient showed no signs of bleeding for 10 days after the procedure; subsequently, she was discharged and followed up for regular checkups.

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Safety of endoscopic resection for duodenal subepithelial lesions with wound closure using clips and an endoloop: an analysis of 68 cases

Abstract: Endoscopic resection with wound closure using clips and an endoloop is an effective and reasonably safe therapeutic method for treating/removing duodenal SELs when managed by an experienced endoscopic team, and it can provide an alternative treatment option for patients with duodenal SELs.

Cited by 21 publications

References 23 publications

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

The Use of Endoscopic Clipping in Preventing Delayed Complications after Endoscopic Resection for Superficial Non-Ampullary Duodenal Tumors

A Case of a Bleeding Duodenal Lipoma Successfully Controlled by Endoscopic Resection

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