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Kato et al. Mini-invasive Surg 2022;6:10 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.124

Review Open Access

ESD for duodenal carcinoma

1
2
1
Motohiko Kato , Motoki Sasaki , Tadateru Maehata , Naohisa Yahagi 1
1
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine,
Tokyo 160-8582, Japan.
2
Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine,
Kawasaki 216-8511, Japan.
Correspondence to: Prof. Motohiko Kato, Division of Research and Development for Minimally Invasive Treatment, Cancer
Center, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
E-mail: motohikokato@keio.jp
How to cite this article: Kato M, Sasaki M, Maehata T, Yahagi N. ESD for duodenal carcinoma. Mini-invasive Surg 2022;6:10.
https://dx.doi.org/10.20517/2574-1225.2021.124
Received: 30 Oct 2021 First Decision: 27 Dec 2021 Revised: 8 Jan 2022 Accepted: 19 Jan 2022 Published: 15 Feb 2022

Academic Editor: Giulio Belli Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Superficial non-ampullary duodenal epithelial tumors (SNADETs) are rare, but their incidence is increasing
recently. Considering the invasiveness of pancreatoduodenectomy, endoscopic treatment is widely accepted as an
option for maintaining patients’ quality of life. SNADETs larger than 20 mm are an indication for duodenal ESD, and
intramucosal cancer can be cured by ESD. Duodenal ESD is extremely difficult with a high risk of adverse events.
However, some modified treatment techniques such as the water pressure method or the pocket creation method
have been proposed to improve outcomes. Furthermore, evidence is accumulating that protection of the mucosal
defect reduces delayed adverse events after duodenal endoscopic treatments. Moreover, endoscopic drainage of
the bile and pancreatic juice is effective as conservative management even in cases with delayed perforation.

Keywords: Endoscopic resection, duodenum, outcomes

INTRODUCTION
[1,2]
Superficial non-ampullary duodenal epithelial tumors (SNADETs) were considered rare , but, due to
recent developments of endoscopic devices and increasing awareness of endoscopists, the opportunities for
[3,4]
d e t e c t i n g S N A D E T s d u r i n g s c r e e n i n g e s o p h a g o g a s t r o d u o d e n o s c o p y a r e increasing .
Pancreaticoduodenectomy (PD) is the standard surgery for duodenal cancer. However, morbidity and

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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