Management of perforation related to endoscopic submucosal dissection for superficial duodenal epithelial tumors

Seiichiro Fukuhara, Motohiko Kato, Eisuke Iwasaki, Motoki Sasaki, Koshiro Tsutsumi, Yoshiyuki Kiguchi, Teppei Akimoto, Yusaku Takatori, Atsushi Nakayama, Tadateru Maehata, Kazuhiro Minami, Haruhiko Ogata, Takanori Kanai, Naohisa Yahagi

研究成果: Article

3 引用 (Scopus)

抜粋

Background and Aims: Endoscopic submucosal dissection (ESD) is being performed more frequently as a local treatment for superficial duodenal epithelial tumors (SDETs). However, ESD for SDETs is technically difficult because of specific anatomic features that increase the risk of perforation and often require surgery. This study was performed to evaluate the management of ESD-related perforation in patients with SDETs. Methods: Patients who underwent ESD for SDETs from July 2010 to December 2018 were studied. We collected data on complete closure, insertion of endoscopic nasobiliary and pancreatic duct drainage (ENBPD) tubes, and additional interventions. We also evaluated clinical outcomes, including the fasting period, hospital stay, and maximum serum C-reactive protein level. Results: ESD was completed in 264 patients with SDETs. Perforation was observed in 36 patients, including 4 patients with delayed perforation. Among 32 patients with intraoperative perforation, complete closure was achieved in 13 patients. Compared with patients without complete closure, the fasting period and hospital stay were significantly shorter and the maximum serum C-reactive protein level was significantly lower in patients with complete closure, which were equivalent to those in patients without perforation. In patients without complete closure for mucosal defect, no additional interventions were required when an ENBPD tube was inserted, whereas 2 patients without ENBPD tube insertion underwent additional interventions such as percutaneous drainage and a surgical operation. Conclusions: Perforation associated with ESD for SDETs required complex conservative management with complete closure or insertion of an ENBPD tube.

元の言語English
ページ(範囲)1129-1137
ページ数9
ジャーナルGastrointestinal Endoscopy
91
発行部数5
DOI
出版物ステータスPublished - 2020 5

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

フィンガープリント Management of perforation related to endoscopic submucosal dissection for superficial duodenal epithelial tumors' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用