Wide-field underwater EMR followed by line-assisted complete closure for a large duodenal adenoma

摘要

Duodenal adenoma has a risk of developing into cancer. En bloc resection with conventional EMR is difficult for a large lesion, whereas duodenal endoscopic submucosal dissection is associated with a high risk of perforation.’ Piecemeal underwater EMR is effective for large duodenal adenomas; however, a large mucosal defect carries a risk of delayed adverse events.? Although complete closure after endoscopic resection can reduce adverse events,”* closure of a large mucosal defect with endoclips is difficult. Line-assisted complete closure (LACC) enables complete closure.