Successful case of Gel immersion CSP for duodenal adenoma

Abstract

Duodenal adenoma is safely resected with energization by using gel immersion technique.

Recently, cold snare polypectomy (CSP) has been shown to be a promising procedure for the resection of small duodenal adenoma. Since underwater CSP is effective and safe for colorectal diminutive adenoma, we report a case of superficial duodenal adenoma treated using gel immersion CSP. The 8 mm superficial lesion was located at the descending portion of the duodenum. After 200 mL of gelatinous liquid was injected, remaining air in the lumen was suctioned to put the lesion under the gel. Subsequently, the lesion was resected using a specialized snare. Diagnosis was low-grade adenoma with negative surgical margin. No complications were observed. This was the first report of gel immersion CSP for a superficial duodenal adenoma. Using gel immersion instead of water allowed the liquid to remain in the duodenal lumen.