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Endoscopic Surveillance for Duodenal Neoplastic Lesions Tsuneo Oyama 1 , Akiko Takahashi 1 , Nobukazu Yorimitsu 1 1Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan Keyword: 十二指腸癌 , 十二指腸腺腫 , 十二指腸表皮性腫瘍 , 十二指腸ESD pp.1536-1542
Published Date 2016/11/25
DOI https://doi.org/10.11477/mf.1403200764
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 The number of duodenal EMR/ESD at our institute has been increasing. The complication rate for duodenal ESD is higher than that for gastric ESD. Because the duodenal wall is thin, maneuverability is poor, and bile/pancreatic secretions are impaired. Therefore, early detection of small duodenal tumors is important.

 When the endoscope is inserted into the bulb, the duodenal mucosa is sometimes injured mechanically. Therefore, a gentle insertion procedure is required. After the bulb is observed, the endoscope should be turned to the right and angled upward and moved into the second portion of the duodenum. When the endoscope is pulled, its tip can reach the third duodenal portion. If the endoscope is then inserted slightly, its tip will move back, and observation of the second region is possible.

 When the scope is removed after visualization of the third region, the endoscopist must carefully consider the orientation of the scope, as the Vater papilla can be observed on the right or upper side.

 Many parts of the duodenum, including the anal side of the SDA and IDA, are difficult to observe.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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