Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum

Introduction: Endoscopic submucosal dissection for duodenal neoplasms (D-ESD) is considered a technically demanding procedure regarding the high risk of delayed adverse events. Data regarding optimal managements of ulcers after D-ESD are lacking. Methods: A retrospective analysis was performed on consecutive 145 cases of D-ESD for superficial nonampullary duodenal epithelial tumors at a single referral center. Factors related to delayed adverse events and the healing process of ulcers after D-ESD were analyzed. Results: Complete ulcer suture after D-ESD was performed in 128 cases (88%). Two delayed perforation occurred among cases with incomplete suture. Delayed bleeding occurred in 8 cases (6%) within 3 weeks. The ulcer closure rate at second-look endoscopy (SLE) was significantly low among cases with delayed bleeding (12.5% vs. 75%, p = 0.001). The bleeding rate before SLE was significantly high among patients who did not have complete ulcer closure after D-ESD (0.8% vs. 12%, p = 0.036). The ratio of lesions located in the second oral-Vater was significantly low among ulcers re-opened at SLE (38% vs. 14%, p = 0.044). Proton-pump inhibitors (PPIs) were administered for a median of 7 weeks (range 1–8 weeks). At 3 weeks, active ulcer stages were observed in a few cases, and healing or scarring was observed in most cases. Conclusions: Complete ulcer suture was related to decreased risk of delayed adverse events after D-ESD. From the bleeding period and healing process of D-ESD ulcers, the minimum required length of PPI may be 3 weeks after D-ESD.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum ; volume:41 ; number:1 ; year:2023 ; pages:80-88 ; extent:9 ; Digestive diseases ; 41, Heft 1 (2023), 80-88 (gesamt 9)

Contributors, Places and Time

• Creator: Kawamura, Tatsuya ; Hirose, Takashi ; Kakushima, Naomi ; Furukawa, Kazuhiro ; Furune, Satoshi ; Ishikawa, Eri ; Sawada, Tsunaki ; Keiko, Maeda ; Yamamura, Takeshi ; Ishikawa, Takuya ; Ohno, Eizaburo ; Nakamura, Masanao ; Honda, Takashi ; Ishigami, Masatoshi ; Kawashima, Hiroki ; Fujishiro, Mitsuhiro

Further information

• DOI: 10.1159/000522362
• URN: urn:nbn:de:101:1-2023020123281064880120
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:26 AM CEST