[Endoscopic treatment of duodenal Brunner adenoma]

To evaluate the value of endoscopic treatment for duodenal Brunner adenoma.

Twenty-nine cases of duodenal Brunner adenoma were diagnosed by pathology between November 2006 and May 2010 in the Endoscopy Center of Zhongshan Hospital. The clinical data were retrospectively analyzed.

In 29 cases, there were 13 males and 16 females. The median age was 55(29-72) years. The mean adenoma diameter was (1.7 ± 0.1) cm, among which 17 adenomas ranged from 0.5 to 1.0 cm, 6 ranged from 1.0 to 2.0 cm, and 6 greater than 2.0 cm. Nine cases were treated by polypectomy, 12 by endoscopic mucosal resection (EMR), and 8 by endoscopic submucosal dissection(ESD). En-bloc resection rate was 100%. Intraoperative bleeding was seen in one case (200 ml), managed by nonsurgical method, including electrocoagulation, metal clips and nylon rope. Perforation occurred in 1 case during the procedure and was managed by metal clips. Delayed bleeding occurred in 1 case in the second day and was managed endoscopically. During a median follow-up of 13 (range, 2-39) months, the quality of life was satisfactory in this cohort, and no patients developed long-term complications. There was one recurrence within 1 year after the procedure and a second ESD was performed.

Endoscopic treatment is technically feasible and may be considered as the procedure of choice for duodenal Brunner adenoma.