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. 2021 Jul;54(4):563-569.
doi: 10.5946/ce.2020.109. Epub 2020 Nov 24.

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

Jee Young An  1 , Byung-Wook Kim  1 , Joon Sung Kim  1 , Jae-Myung Park  2 , Tae Ho Kim  3 , Jaesin Lee  1
Affiliations

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

Jee Young An et al. Clin Endosc. 2021 Jul.

Abstract

Background/aims: Endoscopic resection (ER) has recently been accepted as the standard treatment modality for superficial nonampullary duodenal tumors (SNADTs). However, the procedure can cause adverse events such as perforation and bleeding. This study aimed to investigate the efficacy of prophylactic clipping in the prevention of delayed complications.

Methods: A retrospective review of the medical records of patients who underwent ER for SNADT from 3 centers was performed. Patients were divided into 2 groups: the immediate clipping group (ICG) and the no clipping group (NCG). Various baseline characteristics and factors associated with the appearance of delayed complications, such as size of the lesion, tumor location, histologic type, and co-morbidities, were compared between the two groups.

Results: A total of 99 lesions from 99 patients were included in this study. Fifty-two patients were allocated into ICG and 47 patients were allocated into NCG. Delayed bleeding occurred in 1 patient from ICG and in 8 patients from NCG. Delayed perforation occurred in 1 patient from ICG and in 3 patients from NCG. There were no procedure-related deaths in both groups.

Conclusion: Although the use of endoscopic clipping seemed to reduce the risk of developing delayed complications, further studies using a prospective design is required.

Keywords: Clipping; Complication; Endoscopic resection; Non-ampullary duodenal tumor.

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Conflict of interest statement

Conflicts of Interest: The authors have no potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Flow diagram of this study. GIST, gastrointestinal stromal tumor.
Fig. 2.
Fig. 2.
Endoscopic clipping after endoscopic mucosal resection for duodenal adenoma. (A) An adenoma is found at the second portion of the duodenum (white arrow heads). (B) Endoscopic mucosal resection with snare is performed. (C) A mucosal defect is noted after endoscopic mucosal resection (white arrow heads). (D) The mucosal defect is closed using an endoscopic clipping device.
See this image and copyright information in PMC

Comment in

References

    1. Fu YW, Lin MS, Yang B, Yu H, Jiao X, Huang JX. An early superficial non-ampullary duodenal tumor cured with endoscopic submucosal dissection: a case report. Oncol Lett. 2017;14:3755–3759. - PMC - PubMed
    1. Klein A, Nayyar D, Bahin FF, et al. Endoscopic mucosal resection of large and giant lateral spreading lesions of the duodenum: success, adverse events, and long-term outcomes. Gastrointest Endosc. 2016;84:688–696. - PubMed
    1. Shibagaki K, Ishimura N, Kinoshita Y. Endoscopic submucosal dissection for duodenal tumors. Ann Transl Med. 2017;5:188. - PMC - PubMed
    1. Cortese AF, Cornell GN. Carcinoma of the duodenum. Cancer. 1972;29:1010–1015. - PubMed
    1. Kakushima N, Kanemoto H, Tanaka M, Takizawa K, Ono H. Treatment for superficial non-ampullary duodenal epithelial tumors. World J Gastroenterol. 2014;20:12501–12508. - PMC - PubMed

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