The Conundrum in Endoscopic Management of Duodenal Polyps: A Tertiary Cancer Center Experience

Abstract

ABSTRACT Background Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps. Research Design and Methods Patients were included if they had pathologically confirmed non-ampullary duodenal polyps that were either sporadic or familial adenomatous polyposis syndrome-related and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report findings. Results A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD. Conclusion Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance for duodenal adenomas should be a focus of future study.