The conundrum in endoscopic management of duodenal polyps: a tertiary cancer center experience

Expert Rev Gastroenterol Hepatol. 2022 Jun;16(6):569-576. doi: 10.1080/17474124.2022.2088508. Epub 2022 Jun 16.

Abstract

Background: Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.

Research design and methods: Patients were included if they had pathologically confirmed non-ampullary duodenal polyps and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report the findings.

Results: A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years, and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention occurred in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.

Conclusion: Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance of duodenal adenomas should be a focus of future study.

Keywords: Duodenal endoscopic mucosal resection; duodenal adenoma; duodenal polyps; management of perforation.

MeSH terms

  • Adenoma* / diagnostic imaging
  • Adenoma* / etiology
  • Adenoma* / surgery
  • Aged
  • Duodenal Diseases*
  • Duodenal Neoplasms* / etiology
  • Duodenal Neoplasms* / surgery
  • Endoscopic Mucosal Resection* / adverse effects
  • Endoscopic Mucosal Resection* / methods
  • Female
  • Humans
  • Intestinal Polyps / etiology
  • Intestinal Polyps / surgery
  • Male
  • Neoplasm Recurrence, Local / epidemiology
  • Retrospective Studies
  • Treatment Outcome