ArticleSurgical endoscopy2025
Risk factors for delayed bleeding after endoscopic resection of non-ampullary duodenal epithelial tumors and the effectiveness of complete mucosal closure in high-risk patients.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Prophylactic mucosal defect closure reduces delayed adverse events after endoscopic resection of large-to-giant laterally spreading superficial non-ampullary duodenal epithelial tumors.Surgical endoscopy · 2026Article
- Octreotide for prevention of delayed bleeding after endoscopic mucosal resection for large superficial non-ampullary duodenal tumors.Endoscopy international open · 2026Article
- Feasibility of pancreatic duct stent placement before endoscopic submucosal dissection for superficial duodenal neoplasms adjacent to the papilla.Clinical endoscopy · 2026Article
- Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection.World journal of gastrointestinal endoscopy · 2025Review
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12 authors.
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Abstract
backgroundEndoscopic resection (ER) of non-ampullary duodenal epithelial tumors (NADETs) is associated with a high incidence of delayed bleeding (DB). While previous reports have identified composite risk factors for delayed adverse events, including both DB and delayed perforation, the specific factors associated with DB remain unclear. This study aimed to identify factors associated with DB after ER of NADETs.
methodsThis retrospective study included 335 consecutive patients who underwent ER for a NADET between January 2004 and December 2023. Participants were divided into the DB and non-DB groups. We compared baseline characteristics and clinical outcomes between the two groups to identify factors associated with DB. ER included endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) techniques. DB was defined as bleeding that required endoscopic hemostasis or transfusion after ER. Complete mucosal closure (CMC) was defined as the complete closure of the defect with no endoscopically visible exposure of the defect.
resultsOverall, 128 ESD procedures and 207 non-ESD procedures were performed. DB occurred in 13 patients (3.9%) and its incidence was lower when CMC was achieved (1.1% vs. 13.9%, P < 0.001). Multivariate analysis revealed the use of antithrombotic agents (odds ratio (OR) 3.8; 95% confidence interval (CI): 1.0-14.6, P = 0.048) and a defect circumference ≥ 1/2 (OR 6.2; 95% CI 1.2-30.5, P = 0.029) as risk factors for DB, and CMC (OR 0.19, 95% CI 0.038-0.95, P = 0.043) as a protective factor. Among the 66 patients with risk factors, including the use of antithrombotic agents and/or a defect circumference ≥ 1/2, CMC reduced the incidence of DB (4.5% [2/44], vs. 31.8% [7/22], P = 0.005).
conclusionWe identified significant factors associated with DB after duodenal ER. Particularly, in patients with risk factors for DB, CMC can reduce the incidence of DB.
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