Approach to the endoscopic resection of duodenal lesions

查看全文 作　　者：Jonathan P [1]Gaspar;Edward B [2]Stelow;Andrew Y [1]Wang

机构地区：[1]Division of Gastroenterology and Hepatology,University of Virginia Health System,Charlottesville,VA 22908,United States;[2]Department of Pathology,University of Virginia,Charlottesville,VA 22908,United States

出　　处：《World Journal of Gastroenterology》索引2016年第22卷第2期,共18页

摘　　要：Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection. Brunner's gland tumors, solitary Peutz-Jeghers polyps, and non-ampullary and ampullary adenomas are mucosally-based duodenal lesions, which can require removal and are typically amenable to endoscopic resection. Several anatomic characteristics of the duodenum make endoscopic resection of duodenal lesions challenging. However, advanced endoscopic techniques exist that enable the resection of large mucosally-based duodenal lesions. Endoscopic papillectomy is not without risk, but this procedure can effectively resect ampullary adenomas and allows patients to avoid surgery, which typically involves pancreaticoduodenectomy. Endoscopic mucosal resection and its variations(such as cap-assisted, cap-band-assisted, and underwater techniques) enable the safe and effective resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum. 关键词：DUODENUM POLYP Subepithelial Lesion AMPULLA Adenoma PAPILLECTOMY ENDOSCOPIC mucosalresection Underwater ENDOSCOPIC SUBMUCOSAL dissection

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Approach to the endoscopic resection of duodenal lesions

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耦合文献(17)

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