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Nonsurgical management of small-bowel polyps in Peutz-Jeghers syndrome with extensive polypectomy by using

Hirotsugu Sakamoto1, Hironori Yamamoto, Yoshikazu Hayashi

  • 1Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.

Gastrointestinal Endoscopy
|June 28, 2011
PubMed

Insights

Double-balloon endoscopy (DBE) effectively manages small-bowel polyps in Peutz-Jeghers syndrome (PJS) patients. This endoscopic approach is safe and reduces the need for surgery.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Gastrointestinal Surgery

Background:

  • Peutz-Jeghers syndrome (PJS) management is complicated by small-bowel polyps, leading to intussusception and bleeding.
  • Double-balloon endoscopy (DBE) offers a minimally invasive option for resecting these polyps.

Purpose of the Study:

  • To evaluate the efficacy and safety of using DBE for endoscopic management of small-bowel polyps in PJS patients.
  • To assess the long-term rate of laparotomy after DBE procedures.

Main Methods:

  • A retrospective chart review was conducted at a single university hospital.
  • Fifteen PJS patients underwent multiple DBE sessions for polyp evaluation and treatment between 2000 and 2009.
  • Efficacy, safety, and laparotomy rates were the primary outcome measures.

Main Results:

  • The mean number and size of resected polyps significantly decreased with successive DBE sessions (P = .02 and P = .01, respectively).
  • One patient experienced a perforation managed conservatively; other complications included pancreatitis (n=2) and bleeding (n=2).
  • Only one patient required surgery for intussusception during the study period.

Conclusions:

  • DBE is a safe and effective endoscopic treatment for small-bowel polyps in PJS patients.
  • This approach can help avoid urgent laparotomies, improving patient outcomes.
Abstract

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