PMID- 36945191 OWN - NLM STAT- MEDLINE DCOM- 20231113 LR - 20231113 IS - 1443-1661 (Electronic) IS - 0915-5635 (Linking) VI - 35 IP - 7 DP - 2023 Nov TI - Clinical course and management of adverse events after endoscopic resection of superficial duodenal epithelial tumors: Multicenter retrospective study. PG - 879-888 LID - 10.1111/den.14552 [doi] AB - OBJECTIVES: This study aimed to elucidate the clinical course and management of adverse events (AEs) after endoscopic resection (ER) for superficial duodenal epithelial tumors (SDETs). METHODS: Consecutive patients who underwent ER of SDETs between January 2008 and July 2018 at 18 Japanese institutions were retrospectively enrolled. The study outcomes included the clinical course, management, and risk of surgical conversion with perioperative AEs after ER for SDETs. RESULTS: Of the 226 patients with AEs, the surgical conversion rate was 8.0% (18/226), including 3.7% (4/108), 1.0% (1/99), and 50.0% (12/24) of patients with intraoperative perforation, delayed bleeding, or delayed perforation, respectively. In the multivariate logistic analysis, involvement of the major papilla (odds ratio [OR] 12.788; 95% confidence interval [CI] 2.098-77.961, P = 0.006) and delayed perforation (OR 37.054; 95% CI 10.219-134.366, P < 0.001) were significant risk factors for surgical conversion after AEs. Delayed bleeding occurred from postoperative days 1-14 or more, whereas delayed perforation occurred within 3 days in all cases. CONCLUSIONS: The surgical conversion rate was higher for delayed perforation than those for other AEs after ER of SDETs. Involvement of the major papilla and delayed perforation were significant risk factors for surgical conversion following AEs. In addition, reliable prevention of delayed perforation is required for 3 days after duodenal ER to prevent the need for surgical interventions. CI - (c) 2023 Japan Gastroenterological Endoscopy Society. FAU - Dohi, Osamu AU - Dohi O AUID- ORCID: 0000-0002-0498-0144 AD - Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Kato, Motohiko AU - Kato M AUID- ORCID: 0000-0002-7579-1316 AD - Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan. FAU - Takeuchi, Yoji AU - Takeuchi Y AUID- ORCID: 0000-0003-3814-298X AD - Department of Gastrointestinal Oncology and Division of Hereditary Tumors, Department of Genetic Oncology, Osaka International Cancer Institute, Osaka, Japan. FAU - Hoteya, Shu AU - Hoteya S AD - Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. FAU - Oyama, Tsuneo AU - Oyama T AD - Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan. FAU - Nonaka, Satoru AU - Nonaka S AD - Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. FAU - Yoshimizu, Shoichi AU - Yoshimizu S AUID- ORCID: 0000-0002-2936-4612 AD - Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan. FAU - Yoshida, Masao AU - Yoshida M AUID- ORCID: 0000-0001-7272-0187 AD - Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan. FAU - Ohata, Ken AU - Ohata K AD - Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan. FAU - Miura, Yoshimasa AU - Miura Y AD - Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan. FAU - Hara, Yuko AU - Hara Y AD - Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. FAU - Tsuji, Shigetsugu AU - Tsuji S AD - Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan. FAU - Yamasaki, Yasushi AU - Yamasaki Y AUID- ORCID: 0000-0002-2992-9863 AD - Department of Gastroenterology, Okayama University Hospital, Okayama, Japan. FAU - Ueyama, Hiroya AU - Ueyama H AUID- ORCID: 0000-0002-5370-1009 AD - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. FAU - Kurahara, Koichi AU - Kurahara K AD - Division of Gastroenterology, Matsuyama Red Cross Hospital, Ehime, Japan. FAU - Tashima, Tomoaki AU - Tashima T AUID- ORCID: 0000-0003-4515-5543 AD - Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan. FAU - Abe, Nobutsugu AU - Abe N AD - Department of Gastroenterological and General Surgery, Kyorin University Faculty of Medicine, Tokyo, Japan. FAU - Nakayama, Atsushi AU - Nakayama A AUID- ORCID: 0000-0001-6487-504X AD - Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan. FAU - Oda, Ichiro AU - Oda I AD - Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. FAU - Yahagi, Naohisa AU - Yahagi N AD - Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230423 PL - Australia TA - Dig Endosc JT - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society JID - 9101419 SB - IM MH - Humans MH - Retrospective Studies MH - Treatment Outcome MH - *Duodenal Neoplasms/surgery/pathology MH - *Carcinoma MH - *Ampulla of Vater/pathology MH - Disease Progression MH - *Endoscopic Mucosal Resection/adverse effects OTO - NOTNLM OT - adverse event OT - delayed perforation OT - endoscopic resection OT - superficial duodenal epithelial tumor OT - surgical conversion EDAT- 2023/03/23 06:00 MHDA- 2023/11/13 06:42 CRDT- 2023/03/22 01:43 PHST- 2022/12/27 00:00 [received] PHST- 2023/03/19 00:00 [accepted] PHST- 2023/11/13 06:42 [medline] PHST- 2023/03/23 06:00 [pubmed] PHST- 2023/03/22 01:43 [entrez] AID - 10.1111/den.14552 [doi] PST - ppublish SO - Dig Endosc. 2023 Nov;35(7):879-888. doi: 10.1111/den.14552. Epub 2023 Apr 23.