ESD FOR SUPERFICIAL DUODENAL EPITHELIAL TUMORS

Abstract

ESD is a minimally invasive treatment for superficial duodenal epithelial tumors (SDETs), with a high en bloc resection rate. However, the unique anatomy of the duodenum poses technical challenges and increases the risk of adverse events, requiring highly skilled endoscopists and robust medical support. Recent advances in resection techniques and devices have improved the safety of ESD. Additionally, prophylactic mucosal defect closure and bile/pancreatic duct drainage can prevent delayed adverse events. Duodenal ESD has demonstrated extremely low recurrence rates and favorable long-term outcomes. ESD, including the papilla, has become an alternative to endoscopic papillectomy or pancreatoduodenectomy, contingent on careful patient selection. Safe duodenal ESD implementation requires a multidisciplinary team, including experienced endoscopists, biliopancreatic endoscopists, gastrointestinal surgeons, and interventional radiologists.