The Medical School, Ningbo University, Ningbo, China.
The Gastroenterology Department, Ningbo First Hospital, Ningbo, China.
Scand J Gastroenterol. 2021 May;56(5):604-612. doi: 10.1080/00365521.2021.1900384. Epub 2021 Mar 17.
Though superficial non-ampullary duodenal epithelial tumors (SNADETs) have been traditionally considered rare, there is a growing detection under the development and widespread of endoscopic techniques in recent times. Many case studies have revealed early manifestations of lesions through advanced endoscopic technology, however, because of the low incidence of duodenal tumors and challenges in diagnosing, the preoperative diagnosis criteria have not been established so far. In spite of this, recently the increasing detection rate of early duodenal epithelial lesions enhances the demand for minimally invasive treatment as well. The most suitable therapeutic endoscopic modality to remove duodenal lesions should be selected according to the size, location and histological invasive depth of duodenal lesions. Nevertheless, due to the special anatomical structure of the duodenum, the incidence of complications is much higher than in any other part of the digestive tract. To prevent these adverse events prophylactically, a few novel strategies have been applied effectively after resection. This review describes the current status of preoperative endoscopic diagnosis and endoscopic resection approaches, as well as countermeasures for avoiding procedure-related complications.
虽然传统上认为浅表性非壶腹十二指肠上皮肿瘤（SNADETs）较为罕见，但近年来随着内镜技术的发展和广泛应用，其检出率逐渐增高。许多病例研究通过先进的内镜技术揭示了病变的早期表现，然而，由于十二指肠肿瘤的发病率较低以及诊断的挑战，迄今为止尚未建立术前诊断标准。尽管如此，最近早期十二指肠上皮病变的检出率不断增加，也增加了对微创治疗的需求。应根据十二指肠病变的大小、位置和组织学浸润深度选择最适合的治疗性内镜方法切除。然而，由于十二指肠的特殊解剖结构，其并发症的发生率远高于消化道的其他任何部位。为了预防这些不良事件，在切除后已经采取了一些新的策略来进行预防性处理。本文描述了目前术前内镜诊断和内镜切除方法的现状，以及避免与操作相关的并发症的对策。
