Endoscopic mucosal resection/endoscopic submucosal dissection for gastric heterotopic pancreas.

BACKGROUND/AIMS: To study the features of gastric heterotopic pancreas and to evaluate the feasibility, efficacy, and safety of endoscopic resection for treatment of this condition.

MATERIALS AND METHODS

Between August 2007 and December 2010, 60 gastric heterotopic pancreas patients were treated using endoscopic mucosal resection/endoscopic submucosal dissection. The definitive histological diagnosis of heterotopic pancreas was made after the endoscopic treatment. Tumor size, site, layer, complete resection rate, complications, and local recurrence rate were evaluated.

RESULTS

The mean tumor diameter was 1.4±0.1 (0.4-3.5) cm in the 60 gastric heterotopic pancreass patients during this period. Fourteen cases (23.3%, 14/60) underwent endoscopic mucosal resection, and the en bloc resection rate was 64.3% (9/14). In 3 cases (21.4%, 3/14), arterial bleeding was controlled with hot biopsy forceps or a metal clip during endoscopic mucosal resection. Forty six cases (76.7%, 46/60) underwent endoscopic submucosal dissection procedure, and the en bloc resection rate was 97.8% (45/46). In 6/45 cases (13.3%), arterial bleeding occurred. Pneumoperitoneum developed in 3 cases (6.5%, 3/46) during the operation. The curative resection rate was 98.3% (59/60). There were no recurrences in any cases.

CONCLUSION

Endoscopic mucosal resection/endoscopic submucosal dissection is a minimally-invasive technique that allows resection of whole lesions and provides precise histological information, which is particularly suitable for gastric heterotopic pancreas.