Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E734
DOI: 10.1055/a-1799-7857
Letter to the editor

Endoscopic submucosal dissection in the duodenum: Ready for prime time?

Maximilien Barret
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
,
Maxime Amoyel
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

We thank Enrique Perez-Cuadrado-Robles and Pierre Deprez for their comments. We concur with them on the fact that delayed perforation represents a minority (10 %–20 %) of all perforations after duodenal ESD [1] [2] [3]. In our eyes, however, this number is unacceptably high, considering that management of such patients can require emergent duodenopancreatectomy and is associated with significant morbidity. In addition, perprocedural perforations during duodenal ESD are very different from those occurring during resections in other parts of the gastrointestinal tract: In a series of 36 duodenal perforations after ESD, Fukuhara et al. showed that complete endoscopic closure of an intraoperative perforation, even in expert hands, was only achieved in 41 % of patients, resulting in long and complex medical management, with a median (range) of 12 days (4–58) of hospital admission in these patients [1].



Publication History

Article published online:
10 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Fukuhara S, Kato M, Iwasaki E. et al. Management of perforation related to endoscopic submucosal dissection for superficial duodenal epithelial tumors. Gastrointest Endosc 2020; 91: 1129-1137
    CrossrefPubMedGoogle Scholar
  • 2 Pérez-Cuadrado-Robles E, Quénéhervé L, Margos W. Comparative analysis of ESD versus EMR in a large European series of non-ampullary superficial duodenal tumors. Endosc Int Open 2018; 6: E1008-E1014
    PubMedGoogle Scholar
  • 3 Kato M, Takeuchi Y, Hoteya S. Outcomes of endoscopic resection for superficial duodenal tumors: 10 years' experience in 18 Japanese high volume centers. Endoscopy 2021; DOI: 10.1055/a-1640-3236.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Pérez-Cuadrado-Robles E, Quénéhervé L, Margos W. et al. ESD versus EMR in non-ampullary superficial duodenal tumors: a systematic review and meta-analysis. Endosc Int Open 2018; 6: E998-E1007
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Kato M, Sasaki M, Mizutani M. et al. Predictors of technical difficulty with duodenal ESD. Endosc Int Open 2019; 7: E1755-E1760
    Article in Thieme ConnectPubMedGoogle Scholar