Therapeutic value of endoscopy for primary duodenal lesions
10.3760/cma.j.issn.1007-5232.2019.05.005
- VernacularTitle:内镜在原发性十二指肠占位性病变中的应用价值
- Author:
Yongqiu WEI
1
;
Qiaozhi ZHOU
;
Peng LI
;
Ming JI
;
Yinglin NIU
;
Yongjun WANG
;
Shutian ZHANG
;
Siying ZHU
Author Information
1. 首都医科大学附属北京友谊医院消化内科 国家消化系统疾病临床医学研究中心首都医科大学消化病学系 消化疾病癌前病变北京市重点实验室 100050
- Keywords:
Duodenal disease;
Endoscopy;
Endoscopic mucosal resection;
Endoscopic submucosal dissection
- From:
Chinese Journal of Digestive Endoscopy
2019;36(5):323-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the therapeutic value of endoscopy for primary duodenal lesions. Methods Data of 79 consecutive patients with primary duodenal lesions, who underwent endoscopic treatment from January 2015 to January 2018 at Beijing Friendship Hospital, were retrospectively analyzed. Patients were divided into the complication group and the non-complication group, and further grouped according to lesion locations and endoscopic categories. Baseline data of patients, endoscopic treatment, wound closure method, pathological results, the occurrence and outcome of complications were studied. Results A total of 79 patients successfully went through endoscopic treatment, including 59 cases of endoscopic mucosal resection ( EMR) , 5 cases of endoscopic submucosal dissection ( ESD) , 6 cases of full-thickness resection with OTSC metal clips, and 9 cases of endoscopic piecemeal mucosal resection ( EPMR) . In all 79 cases, complications occurred in 8 patients ( 10. 1％) during the perioperative period, all at the duodenal descending segment and duodenal papilla. In all 47 cases whose lesions located at duodenal papilla and duodenal descending segment, the complication incidence was 17. 0％ ( 8/47) , significantly higher than that of non-descending and papilla part [ 0 ( 0/32 ) , P=0. 012 ] . Two ( 2. 5％) cases had complications requiring further intervention with endoscopy or surgery. Among 8 patients with complications, 1 patient ( 2. 1％) developed intraoperative perforation, 1 patient ( 2. 1％) developed delayed bleeding, 6 patients ( 12. 8％) developed mild acute pancreatitis, and these 8 patients recovered after treatment. These 47 patients were further divided into the duodenoscopy group and the gastroscopy group according to endoscopic categories, the complications incidence in the duodenoscopy group ( 28. 0％, 7/25) was also significantly higher than that in the gastroscopy group [ 4. 5％( 1/22) , P=0. 037] . Conclusion Endoscopic treatment is safe and effective for primary duodenal lesions. But for the operations in the duodenal descending segment and the duodenal papilla, as well as in the case of duodenoscopy, it is necessary to be more vigilant about the occurrence of complications.
