Endoscopic submucosal dissection and submucosal tunneling endoscopic resection for gastric ectopic pancreas

Abstract

Objective To investigate endoscopic submucosal dissection （ESD） and submucosal tunneling endoscopic resection （STER） for the diagnosis and therapy of gastric ectopic pancreas. Methods The patients who diagnosed with gastric ectopic pancreas by gastroscope and demanded endo-scopic resection received ESD or STER in hospital, the lesions were definitely diagnosed by pathology, and the therapeutic effect and safety were followed-up. Results A total of 40 patients received ESD or STER from October 2009 to March 2013, 25 gastric ectopic pancreases were definitely diagnosed by pathology. Of the 25 patients, 20 lesions were located at the antrum, 3 fundus-body of stomach, 2 body of stomach; 20 pancreatic tissue were crumby,5 were diffused distribution 5 cases. Of the 25 cases,21 patients received ESD, 4 received STER, 88% （22/25） lesions were completely resected. Three lesions had a little tissue re- sidual after resection, 1 （4%） patient developed a massive delay-bleeding which was stopped with hemo- clips. None perforation occurred during operation and postoperation. No recurrence was observed in patients followed up 1 to 30 months. Conclusion ESD could resect the whole lesion to offer an accurate pathology diagnose, meanwhile good for treatment, ESD is an effective and relatively safe method for gastric ectopic pancreas, STER may be a new approach for gastric ectopic pancreas. Key words: Ectopic pancreas; Endoscopic submucosal dissection; Endoscopic ultrasonography; Tunneling