Endoscopy 2019; 51(04): S118
DOI: 10.1055/s-0039-1681517
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 14:30 – 16:00: Duodenum Club E
Georg Thieme Verlag KG Stuttgart · New York

PROPHYLACTIC CLIPPING FOR THE PREVENTION OF DELAYED COMPLICATION AFTER ENDOSCOPIC RESECTION FOR SUPERFICIAL NON-AMPULLARY DUODENAL TUMOR

JY An
1   The Catholic University of Korea, Internal Medicine, Incheon, Korea, Republic of
,
BW Kim
1   The Catholic University of Korea, Internal Medicine, Incheon, Korea, Republic of
,
JM Park
2   The Catholic University of Korea, Internal Medicine, Seoul, Korea, Republic of
,
TH Kim
3   The Catholic University of Korea, Internal Medicine, Bucheon, Korea, Republic of
,
J Lee
3   The Catholic University of Korea, Internal Medicine, Bucheon, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Although endoscopic resection (ER) has been accepted as a standard treatment modality for superficial non-ampullary duodenal tumor (SNADT) recently, it can cause adverse events such as perforation and bleeding. The effect of prophylactic mucosal closure after ER is controversial. The aim of this study was to investigate the efficacy of prophylactic clipping for the prevention of delayed complications.

Methods:

We retrospectively reviewed medical records of patients who underwent ER for SNADT from 3 centers. Patients were divided into 2 groups, immediate clipping group (ICG) vs. no clipping group (NCG). Baseline characteristics and factors associated with delayed complications such as size of the lesion, tumor location, histologic types, and co-morbidities were compared between the two groups.

Results:

A total of 91 lesions from 91 patients were included in this study. Six patients underwent ESD and 85 patients underwent EMR. Forty seven patients were allocated into ICG and 44 patients were allocated into NGC. Delayed bleeding occurred in 1 patient (2.1%) and delayed perforation occurred in 1 patient (2.1%) among ICG. Delayed bleeding occurred in 6 patients (13.6%, p = 0.053) and delayed perforation occurred in 3 patients (6.8%, p = 0.350) in NCG. Delayed perforation were managed by laparoscopic simple closure and delayed bleeding were managed by endoscopic hemostasis (n = 6) or embolization (n = 1). There was no procedure related death.

Conclusions:

Although prophylactic clipping showed a tendency of low complication rates, further studies with prospective design is anticipated.