Efficacy and safety of endoscopic submucosal dissection versus endoscopic papillectomy for managing laterally spreading duodenal papillary tumors

Abstract

Background/Aim: Endoscopic submucosal dissection (ESD) can be performed to treat laterally spreading duodenal papillary tumors(LSPTs). However, no studies have been conducted on the outcomes of ESD for LSPTs. Methods: We retrospectively compared 47 patients who underwent endoscopic papillectomy (EP) for papillary tumors (PTs) betweenJune 2007 and July 2023 (EP group) and eight patients who underwent ESD for LSPTs between February 2022 and July 2023 (ESDgroup). In the subgroup analysis, five patients who underwent EP for LSPTs were compared with eight patients who underwent ESDfor LSPTs. Results: Procedure times and tumor diameters were significantly greater in the ESD group than in the EP group. The positive or unclearvertical margin (VM1/X) rate was significantly higher in the ESD group. Additional therapies were administered for patients withVM1/X in the ESD group, and no local recurrence was observed. No delayed adverse events occurred in the ESD group; however, delayedbleeding and perforation occurred in the EP group. In the subgroup analysis, the en bloc resection rate was significantly higher inthe ESD group than in the EP group. The VM1/X rate did not differ significantly between groups. Conclusions: We suggest that ESD is both feasible and safe for LSPTs.