Application of clip traction to endoscopic submucosal dissection for heterotopic pancreas in stomach

Abstract

Objective To evaluate the efficacy and safety of clip traction in endoscopic submucosal dissection (ESD) for heterotopic pancreas in stomach. Methods Data of 62 patients with pathologically confirmed heterotopic pancreas treated by ESD between May 2013 and February 2016 were retrospectively studied in Department of Gastroenterology of Xinqiao Hospital, whose lesions were single and origins were submucosal. Thirty-six cases underwent ESD with clip traction (clip group, n=36), and 26 cases underwent ESD without clip traction(non-clip group, n=26). The procedure time, visualization of the submucosal during dissection, complications and the result of follow-up were evaluated between the two groups. Results ESD was successful in all cases. The procedure time was significantly shorter in the clip group than in the non-clip group (19.35±10.34 min VS 27.02±14.27 min, t′=2.333, P=0.023), and good visualization was obtained by applying clip traction. The rate of bleeding in the clip group was 55.6%(20/36), and that in the non-clip group was 61.5%(16/26). There was no significant difference between the two groups(χ2=0.222, P=0.638). Moreover, perforation did not occur in the clip group, but occurred in one patient in the non-clip group(3.8%, 1/26). There was no significant difference between the two groups(P=0.419). All patients were followed up, there was no recurrence. Conclusion ESD is effective and safe for heterotopic pancreas in stomach. Clip traction can shorten the operation time and reduce complications of ESD. Key words: Endoscopes; Heterotopic, pancreas; Adjuvant, traction; Endoscopic submucosal dissection