Endoscopic Resection for Non‑ampullary Duodenal Lesions: 13 Years of Experience from a Large Tertiary Center in China

Endoscopic resection (ER) has gradually emerged as an optional treatment method for non-ampullary duodenal lesions (NADLs); however, this procedure is associated with technical challenges and a notable risk of adverse events (AEs). The present study aimed to evaluate the efficacy and safety of ER for NADLs in a real-world clinical setting.

This was a retrospective observational study. Patients who received ER for NADLs were consecutively enrolled between January 2012 and December 2024. A total of 262 patients with a median (interquartile range) follow-up period of 24.0 (12.0-48.0) months were included, comprising 178 with epithelial lesions and 84 with subepithelial lesions. Patient demographics, clinical characteristics, and treatment outcomes were systematically documented and compared. Additionally, the associations between clinical variables and the occurrence of AEs were also analyzed.

The en bloc and complete resection rates were 88.8% and 84.3%, respectively, for epithelial lesions and 88.1% and 86.9%, respectively, for subepithelial lesions. Lesions located in the duodenal junction (odds ratio [OR] 8.97; 95% confidence interval [CI] 1.92-41.98) and clipping closure (OR 0.39; 95% CI 0.17-0.87) were identified as independent predictors of AEs in the epithelial lesion group, whereas intraoperative perforation (OR 12.32; 95% CI 2.03-74.60) and size of defect (OR 3.34; 95% CI 1.46-7.63) were identified in the subepithelial group.

ER is a relatively effective and safe therapeutic approach for NADLs in real-world practice, with a controllable risk of AEs and a low recurrence rate. Clinicians should pay more attention to postprocedural care for patients with duodenal junction lesions, intraoperative perforation, or large defects.