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Duodenal mucosal autotransplantation.

Kambiz Kadkhodayan1, Shayan Irani2, Saurabh Chandan1

  • 1Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.

Videogie : an Official Video Journal of the American Society for Gastrointestinal Endoscopy
|October 27, 2025
PubMed
Summary

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Duodenal mucosal autotransplantation (DAT) successfully closed large defects after endoscopic resection of duodenal adenomas. This technique prevented strictures, offering a promising solution for complex duodenal lesion management.

Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Regenerative Medicine

Background:

  • Managing large defects and preventing strictures after endoscopic mucosal resection (EMR) of duodenal lesions is challenging.
  • Duodenal mucosal autotransplantation (DAT) presents a novel approach for defect closure and stricture prevention.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of duodenal mucosal autotransplantation (DAT) for closing large defects after EMR of duodenal adenomas.
  • To assess the potential of DAT in preventing post-resection strictures.

Main Methods:

  • A 57-year-old female underwent piecemeal EMR for a large duodenal adenoma.
  • A 2x2 cm duodenal mucosal autograft was harvested and secured to the resection bed using helical tacks and hemostatic clips.

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  • The defect was closed completely without compromising luminal integrity.

    • Main Results:

    • Follow-up endoscopy at 6 weeks showed successful graft incorporation, intact fixation devices, and no evidence of duodenal stricture.
    • Biopsies confirmed healthy mucosa at the recipient site, and the donor site healed well.
    • Histopathology revealed viable duodenal mucosa with submucosal fibrosis, and 6-month follow-up confirmed well-healed sites without stricture.

    Conclusions:

    • Duodenal mucosal autotransplantation (DAT) is a feasible technique for closing large defects after duodenal EMR.
    • DAT shows potential in reducing the risk of duodenal stricture formation.
    • Further research is needed to confirm long-term outcomes and the wider applicability of DAT.