Yongqiu Wei, Qiaozhi Zhou, Peng Li, M. Ji, Y. Niu, Yong-jun Wang, Shutian Zhang
{"title":"内镜对原发性十二指肠病变的治疗价值","authors":"Yongqiu Wei, Qiaozhi Zhou, Peng Li, M. Ji, Y. Niu, Yong-jun Wang, Shutian Zhang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.05.005","DOIUrl":null,"url":null,"abstract":"Objective \nTo study the therapeutic value of endoscopy for primary duodenal lesions. \n \n \nMethods \nData of 79 consecutive patients with primary duodenal lesions, who underwent endoscopic treatment from January 2015 to January 2018 at Beijing Friendship Hospital, were retrospectively analyzed. Patients were divided into the complication group and the non-complication group, and further grouped according to lesion locations and endoscopic categories. Baseline data of patients, endoscopic treatment, wound closure method, pathological results, the occurrence and outcome of complications were studied. \n \n \nResults \nA total of 79 patients successfully went through endoscopic treatment, including 59 cases of endoscopic mucosal resection (EMR), 5 cases of endoscopic submucosal dissection (ESD), 6 cases of full-thickness resection with OTSC metal clips, and 9 cases of endoscopic piecemeal mucosal resection (EPMR). In all 79 cases, complications occurred in 8 patients (10.1%) during the perioperative period, all at the duodenal descending segment and duodenal papilla. In all 47 cases whose lesions located at duodenal papilla and duodenal descending segment, the complication incidence was 17.0% (8/47), significantly higher than that of non-descending and papilla part [0 (0/32), P=0.012]. Two (2.5%) cases had complications requiring further intervention with endoscopy or surgery. Among 8 patients with complications, 1 patient (2.1%) developed intraoperative perforation, 1 patient (2.1%) developed delayed bleeding, 6 patients (12.8%) developed mild acute pancreatitis, and these 8 patients recovered after treatment. These 47 patients were further divided into the duodenoscopy group and the gastroscopy group according to endoscopic categories, the complications incidence in the duodenoscopy group (28.0%, 7/25) was also significantly higher than that in the gastroscopy group [4.5%(1/22), P=0.037]. \n \n \nConclusion \nEndoscopic treatment is safe and effective for primary duodenal lesions. But for the operations in the duodenal descending segment and the duodenal papilla, as well as in the case of duodenoscopy, it is necessary to be more vigilant about the occurrence of complications. \n \n \nKey words: \nDuodenal disease; Endoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection","PeriodicalId":10072,"journal":{"name":"中华消化内镜杂志","volume":"36 1","pages":"323-327"},"PeriodicalIF":0.0000,"publicationDate":"2019-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Therapeutic value of endoscopy for primary duodenal lesions\",\"authors\":\"Yongqiu Wei, Qiaozhi Zhou, Peng Li, M. Ji, Y. Niu, Yong-jun Wang, Shutian Zhang\",\"doi\":\"10.3760/CMA.J.ISSN.1007-5232.2019.05.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo study the therapeutic value of endoscopy for primary duodenal lesions. \\n \\n \\nMethods \\nData of 79 consecutive patients with primary duodenal lesions, who underwent endoscopic treatment from January 2015 to January 2018 at Beijing Friendship Hospital, were retrospectively analyzed. Patients were divided into the complication group and the non-complication group, and further grouped according to lesion locations and endoscopic categories. Baseline data of patients, endoscopic treatment, wound closure method, pathological results, the occurrence and outcome of complications were studied. \\n \\n \\nResults \\nA total of 79 patients successfully went through endoscopic treatment, including 59 cases of endoscopic mucosal resection (EMR), 5 cases of endoscopic submucosal dissection (ESD), 6 cases of full-thickness resection with OTSC metal clips, and 9 cases of endoscopic piecemeal mucosal resection (EPMR). In all 79 cases, complications occurred in 8 patients (10.1%) during the perioperative period, all at the duodenal descending segment and duodenal papilla. In all 47 cases whose lesions located at duodenal papilla and duodenal descending segment, the complication incidence was 17.0% (8/47), significantly higher than that of non-descending and papilla part [0 (0/32), P=0.012]. Two (2.5%) cases had complications requiring further intervention with endoscopy or surgery. Among 8 patients with complications, 1 patient (2.1%) developed intraoperative perforation, 1 patient (2.1%) developed delayed bleeding, 6 patients (12.8%) developed mild acute pancreatitis, and these 8 patients recovered after treatment. These 47 patients were further divided into the duodenoscopy group and the gastroscopy group according to endoscopic categories, the complications incidence in the duodenoscopy group (28.0%, 7/25) was also significantly higher than that in the gastroscopy group [4.5%(1/22), P=0.037]. \\n \\n \\nConclusion \\nEndoscopic treatment is safe and effective for primary duodenal lesions. But for the operations in the duodenal descending segment and the duodenal papilla, as well as in the case of duodenoscopy, it is necessary to be more vigilant about the occurrence of complications. \\n \\n \\nKey words: \\nDuodenal disease; Endoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection\",\"PeriodicalId\":10072,\"journal\":{\"name\":\"中华消化内镜杂志\",\"volume\":\"36 1\",\"pages\":\"323-327\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华消化内镜杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.05.005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华消化内镜杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.05.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Therapeutic value of endoscopy for primary duodenal lesions
Objective
To study the therapeutic value of endoscopy for primary duodenal lesions.
Methods
Data of 79 consecutive patients with primary duodenal lesions, who underwent endoscopic treatment from January 2015 to January 2018 at Beijing Friendship Hospital, were retrospectively analyzed. Patients were divided into the complication group and the non-complication group, and further grouped according to lesion locations and endoscopic categories. Baseline data of patients, endoscopic treatment, wound closure method, pathological results, the occurrence and outcome of complications were studied.
Results
A total of 79 patients successfully went through endoscopic treatment, including 59 cases of endoscopic mucosal resection (EMR), 5 cases of endoscopic submucosal dissection (ESD), 6 cases of full-thickness resection with OTSC metal clips, and 9 cases of endoscopic piecemeal mucosal resection (EPMR). In all 79 cases, complications occurred in 8 patients (10.1%) during the perioperative period, all at the duodenal descending segment and duodenal papilla. In all 47 cases whose lesions located at duodenal papilla and duodenal descending segment, the complication incidence was 17.0% (8/47), significantly higher than that of non-descending and papilla part [0 (0/32), P=0.012]. Two (2.5%) cases had complications requiring further intervention with endoscopy or surgery. Among 8 patients with complications, 1 patient (2.1%) developed intraoperative perforation, 1 patient (2.1%) developed delayed bleeding, 6 patients (12.8%) developed mild acute pancreatitis, and these 8 patients recovered after treatment. These 47 patients were further divided into the duodenoscopy group and the gastroscopy group according to endoscopic categories, the complications incidence in the duodenoscopy group (28.0%, 7/25) was also significantly higher than that in the gastroscopy group [4.5%(1/22), P=0.037].
Conclusion
Endoscopic treatment is safe and effective for primary duodenal lesions. But for the operations in the duodenal descending segment and the duodenal papilla, as well as in the case of duodenoscopy, it is necessary to be more vigilant about the occurrence of complications.
Key words:
Duodenal disease; Endoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection
期刊介绍：
Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy.
Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience.
The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications.
The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research.
Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.
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