부산대학교 도서관

Duodenal adenomas are observed as whitish, flat elevated lesions. The features of mucosal carcinoma are redness, large size, irregular surface, and obscure mucosal pattern on magnifying narrow-band imaging (NBI). It is difficult to make a differential diagnosis between adenoma and carcinoma, and the accuracy of endoscopy or biopsy is reported to be 68-78％. Biopsy may induce submucosal fibrosis, which could hamper subsequent endoscopic resection. Duodenal endoscopic submucosal dissection (ESD) has a high complete resection rate, but is associated with a high risk for perforation. There is a high risk for post-operative adverse events among patients with a duodenal mucosal defect due to exposure to bile and pancreatic juice. It is desirable to perform prophylactic clip closure after duodenal ESD.