GEL IMMERSION EMR FOR SUPERFICIAL NONAMPULLARY DUODENAL EPITHELIAL TUMORS

Abstract

The importance of endoscopic resection for duodenal tumors is increasingly being recognized; however, the high frequency of complications, such as bleeding and perforation, during EMR has become a problem.

In recent years, an increasing number of studies have demonstrated the clinical usefulness of underwater EMR, in which the intestinal lumen is filled with water, and lesions are resected by snaring without injection. This technique has been shown to have a higher en bloc resection rate and a shorter procedure time than conventional EMR. However, some areas are difficult to fill with water, and bile and mucus slime in water can reduce visibility. Therefore, the use of gel immersion EMR (also called undergel EMR), in which lesions are immersed in a gel for endoscopic hemostasis instead of in water, has occasionally been reported. This paper describes the methods and prospects of gel immersion EMR.