Endoscopic submucosal dissection (ESD) of non-ampullary duodenal neoplasms is often
technically difficult because unstable scope operation makes it difficult to ensure
an adequate field of view. In addition, since bile and pancreatic juice flow out of
the papilla of Vater and the duodenal wall is thin, the risk of complications is higher
than in other portions of the gastrointestinal tract. Therefore, immediate endoscopic
closure is important for preventing postoperative complications such as delayed perforation
and post-ESD bleeding secondary to bile and pancreatic juice exposure. Therefore,
we suggest a more secure ESD technique for duodenal tumors that utilizes a “pocket-creation
method” as well as a polyglycolic acid (PGA) felt and fibrin glue sealing with clips
to prevent postoperative complications.
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© 2015 Published by Elsevier Inc.
