Endoscopy 2019; 51(04): S118-S119
DOI: 10.1055/s-0039-1681519
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 14:30 – 16:00: Duodenum Club E
Georg Thieme Verlag KG Stuttgart · New York

COMPLICATIONS AND OUTCOMES AFTER ENDOSCOPIC RESECTION OF SPORADIC DUODENAL ADENOMAS

L Neuhaus
1   III. Medizinische Klinik, Klinikum Augsburg, Augsburg, Germany
,
A Probst
1   III. Medizinische Klinik, Klinikum Augsburg, Augsburg, Germany
,
H Messmann
1   III. Medizinische Klinik, Klinikum Augsburg, Augsburg, Germany
,
S Freund
1   III. Medizinische Klinik, Klinikum Augsburg, Augsburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

To prospectively evaluate the complications and outcomes after endoscopic resection of sporadic duodenal adenomas (SDA).

Methods:

From 10/2015 to 07/2018 endoscopic resections of sporadic ampullary (ASDA) and non-ampullary duodenal adenomas (NASDA) were prospectively registered regarding the localisation, technique of resection, duration of endoscopic therapy, size, histology and complications.

Results:

89 SDAs have been resected in 83 patients. 20 (22.5%) were ampullary and 69 (77.5%) were non-ampullary lesions. The mean size was 22 mm (4 – 60 mm) with a mean circumferentially expansion of 28% of the lumen. Procedure time was longer in in the ASDA group (58 min vs. 38 min). Bleeding after resection was observed in 19% of cases (ASDA: 30%; NASDA: 15.9%; p = 0.14). The risk for bleeding was significantly associated with the size of the adenoma (11% in adenomas < 30 mm and 37% in adenomas ≥30 mm; p = 0.008) 5 of 20 patients with an ampullary adenoma resection developed acute pancreatitis postinterventional (25%). Three cases of intraprocedural perforations were observed which could all be controlled endoscopically. One patient died after cholangitis, formation of a stricture with the consequence of perforation after dilatation.

Conclusions:

The endoscopic resection of even large duodenal adenomas is possible in an experienced center but shows a high frequency of complications of which the most relevant is bleeding. Resections of ASDA are at higher risk for complications compared to NASDA.