| International Session（Workshop）3(JGES・JSGE・JSGS) |
| Sat. November 2nd 9:00 - 12:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Clinical outcomes of the underwater clip closure and over-the scope clip closure for mucosal defects after duodenal endoscopic submucosal dissection | |||
| Mayuko Seya1, Osamu Dohi1, Naoto Iwai1 | |||
| 1Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine | |||
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| Background and Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal epithelial tumors (SNADETs) has a high risk of adverse events (AEs). We have reported underwater clip closure method (UCCM) and over-the scope clip closure (OTSCC) for mucosal defects to prevent the AEs after duodenal ESD. we aimed to compare the effectiveness between UCCM and OTSCC. Methods: We retrospectively investigated consecutive patients with SNADETs who underwent ESD between January 2016 to December 2023. We assessed the clinical course, management, and AEs. UCCM was performed using reopenable clips in underwater conditions. Results: There were 77 UCCM and 81 OTSCC. The median tumor size was larger in UCCM than in OTSCC (23 vs. 15 mm, P<0.001) and the median resection time was longer in UCCM (55 vs. 40 min, P=0.009). The rate of complete closure was 100 % and 98.8 % in UCCM and OTSCC. No significant differences were observed in the median closure time (16 vs. 15 min, P=0.813). The rate of AEs was 6.2% and 2.6% in UCCM and OTSCC with no significant difference (P=0.72): delayed perforation (1.3% vs 2.5%), delayed bleeding (1.3% vs 3.7%), and acute pancreatitis (1.3% vs 0.0%). Conclusions: UCCM is equally effective for prevention of AEs compared to OTSCC regardless of larger mucosal defects. |
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Index Term 1: Duodenum Index Term 2: Endoscopic submucosal dissection |
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