SUBJECT AND METHOD OF DUODENAL ESD INCLUDING PAPILLA

Abstract

Duodenal ESD for ampullary and non-ampullary tumors including papilla (ESD-IP) is a highly advanced treatment. ESD-IP requires management similar to duodenal ESD, without including the papilla but with the addition of resection of the sphincter of Oddi, subsequent cannulation of the bile and pancreatic duct orifices, and postoperative drainage. Therefore, ESD-IP should be performed at high-volume centers with expertise in the anatomical features of the duodenum and appropriate perioperative management. Compared with surgical resection, ESD-IP is less invasive and can provide sufficient safety assurance with appropriate management.