Related Experiment Video
Updated: Jan 2, 2026
Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Predictors of technical difficulty with duodenal ESD.
Motohiko Kato1,2, Motoki Sasaki2, Mari Mizutani1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Predicting technical difficulty in duodenal endoscopic submucosal dissection (ESD) is crucial. Lesion location in flexural areas, larger size (>40mm), and extensive duodenal circumference (>50%) significantly increase the risk of challenging duodenal ESD procedures.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Duodenal endoscopic submucosal dissection (ESD) presents significant technical challenges.
- Objective predictors for duodenal ESD technical difficulty remain under-analyzed.
Purpose of the Study:
- To identify predictors of technical difficulty in duodenal endoscopic submucosal dissection (ESD).
Main Methods:
- Retrospective observational study of 174 patients undergoing duodenal ESD for superficial epithelial neoplasia.
- Technical difficulty defined as procedure time >100 minutes or intraprocedural perforation.
- Multivariate analysis to identify significant risk factors.
Main Results:
- 34.5% of patients experienced technical difficulty during duodenal ESD.
- Key predictors identified: lesion location in flexural areas (OR 2.61), larger lesion size >40mm (OR 5.26), and occupied circumference >50% (OR 5.80).
Conclusions:
- Lesion location in flexural areas, size >40mm, and occupied circumference >50% are significant risk factors for technical difficulty in duodenal ESD.
- These findings can aid in pre-procedural risk assessment and planning for duodenal ESD.
Related Concept Videos
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Endoscopic Procedures V: ERCP
Patient...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.