Feasibility of pancreatic duct stent placement before endoscopic submucosal dissection for superficial duodenal neoplasms adjacent to the papilla
- Author:
Ryosuke KOBAYASHI
1
;
Kingo HIRASAWA
;
Yuichiro OZEKI
;
Atsushi SAWADA
;
Masafumi NISHIO
;
Chiko SATO
;
Haruo MIWA
;
Kazuya SUGIMORI
;
Shin MAEDA
Author Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2026;59(1):89-95
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal epithelial tumors (SNADETs) is technically challenging and is associated with a risk of adverse events, particularly when lesions are located near the major papilla. Pancreatic duct (PD) stent may reduce the risk of post-ESD pancreatitis; however, no standard strategy has been established. This study aimed to evaluate the effectiveness and safety of PD stent placement combined with ESD for SNADETs near the major papilla.
Methods:This was a retrospective study of duodenal ESD after prophylactic PD stent placement in patients with SNADET near the major papilla at a university hospital between March 2014 and September 2023.
Results:Four lesions were located within 5 mm of the major papilla, and seven within 5 to 10 mm. The median interval between stent placement and ESD was 2 days. The en bloc and R0 resection rates were 100% and 90.9%, respectively. No stent migration occurred during ESD, and all mucosal defects were completely closed using endoscopic clips. Delayed bleeding and post-ESD pancreatitis were observed in one and two cases, respectively.
Conclusions:PD stent placement combined with ESD is an effective treatment strategy for SNADETs near the major papilla. However, the risk of post-ESD pancreatitis remains, indicating the need for further preventive strategies.
