Endoscopic Gastroduodenal Polypectomy

Ghazi, Ali; Ferstenberg, Henry; Shinya, Hiromi

doi:10.1097/00000658-198408000-00010

Cited by 59 publications

(32 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[12][13][14] Gastric polyps occur more frequently in certain conditions, with incidences of 22% in cases of pernicious anemia, 1516 6% in cases of chronic atrophic gastritis, 17 and 4% to 20% after partial gastrectomy. 1819 They also occur more frequently in hereditary gastrointestinal polyposis syndromes.…”

Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

1998

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

1998

View full text Add to dashboard Cite

show abstract

“…They may also arise as part of a genetic predisposition such as Familial Adenomatous polyposis (FAP) or Peutz-Jeghers syndrome. Duodenal polyps are uncommon, being reported in 0.3-4.6% of patients who present for Oesophago-GastroDuodenoscopy [5]. Management of all duodenal lesions is dependent on a full evaluation of patient's symptoms, clinical features, endoscopic findings, histology and cross sectional imaging.…”

Section: Introductionmentioning

confidence: 99%

Pancreaticoduodenectomy for nonampullary duodenal lesions: indications and results

Shamali

McCrudden²,

Bhandari

et al. 2016

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Background Pancreaticoduodenectomy (PD) is a complex procedure, associated with a definite risk of mortality and 30–50% risk of complications. For nonampullary duodenal lesions, PD can carry a higher morbidity as they are more commonly associated with a soft pancreas and narrow-calibre main pancreatic ducts. It is therefore paramount that the risks and benefits of surgery are considered carefully in this group of patients. A preoperative histological diagnosis for duodenal lesions is normally achieved by endoscopic biopsy. In this study, we aim to assess the outcome of PD in patients with nonampullary duodenal lesions and correlate the preoperative endoscopic histology work-up with the definitive postoperative pathology. Materials and methods We reviewed a prospectively collected PD database from January 2007 to December 2013. Demographic and clinical data were included. Preoperative endoscopic histology was compared with final specimen histology to assess concordance. Results Forty patients (55% women, mean age 69.4 years, range 45–83 years) underwent PD for duodenal lesions over a 7-year time period. The most common presenting symptom was epigastric pain (32.5%), followed by anaemia (20%). Overall, the complication rate was 55%, with the most frequent adverse event being pancreatic fistula in 13/40 (32.5%). The perioperative mortality was 2/40 (5%). Duodenal adenocarcinoma (65%) was the most common postoperative histological diagnosis. The mean tumour size was 36 mm (range 5–103 mm) and a median of 13 nodes were harvested. The median length of stay was 15 days (range 7–66 days). Overall, 12/40 patients (30%) had a preoperative diagnosis of high-grade dysplasia. The postoperative specimen in this subgroup of patients was reviewed carefully and only 3/12 (25%) patients had high-grade dysplasia in the resection specimen. In the remaining patients, 3/12 (25%) had adenocarcinoma in the resection specimen and 6/12 patients (50%) had low-grade dysplasia. Conclusion PD carries a high mortality and morbidity, especially for duodenal lesions. We recommend a careful endoscopic review after the index case with a high-definition optical evaluation of duodenal lesions. This, in addition to an experienced histological assessment of the index biopsy material, forms an essential prerequisite in aiding the multidisciplinary team in the decision-making process with respect to triage of these lesions to conservative management, surveillance, endoscopic resection or finally surgical resection.

show abstract

“…Duodenal polyps are reported in 0.3-4.6% of patients attending for upper gastrointestinal endoscopy [Ghazi et al 1984;Hochter et al 1984;Jepsen et al 1994;Reddy et al 1981]. Management of these polyps is dependent on symptoms, histopathology and endoscopic features.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic management of nonampullary duodenal polyps

Basford

Bhandari

2011

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Duodenal polyps are a rare finding in patients presenting for gastroscopy, being found in 0.3-4.6% of cases. The majority of patients are asymptomatic. The most common lesions necessitating removal are duodenal adenomas which should be differentiated from other mucosal lesions such as ectopic gastric mucosa, and submucosal lesions such as carcinoids and gastrointestinal stromal tumours (GISTs). Adenomas can occur sporadically or as part of a polyposis syndrome. Both groups carry malignant potential but this is higher in patients with a polyposis syndrome. The majority of sporadic duodenal adenomas are flat or sessile and occur in the second part of the duodenum. Historically duodenal adenomas have been managed by radical surgery, which carried significant mortality and morbidity, or more conservative local surgical excision which resulted in high local recurrence rates. There is growing evidence for the use of endoscopic mucosal resection (EMR) techniques for treatment of sporadic nonampullary duodenal adenomas, with good outcomes and low complication rates. Endoscopic submucosal dissection (ESD) carries greater risk of complications and should be reserved for experts in this technique. Patients with sporadic duodenal adenomas carry an increased risk of colonic neoplasia and should be offered colonoscopy. The impact of endoscopic resection on the course of polyposis syndromes such as familial adenomatous polyposis (FAP) needs further study.

show abstract

Endoscopic Gastroduodenal Polypectomy

Cited by 59 publications

References 6 publications

Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

Pancreaticoduodenectomy for nonampullary duodenal lesions: indications and results

Endoscopic management of nonampullary duodenal polyps

Contact Info

Product

Resources

About