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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(01): E96-E108
DOI: 10.1055/a-1723-2847
Review

Endoscopic management of non-ampullary duodenal adenomas

Maxime Amoyel
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Arthur Belle
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Marion Dhooge
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Einas Abou Ali
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
3   University of Paris, France.
,
Rachel Hallit
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
3   University of Paris, France.
,
Frederic Prat
2   Gastroenterology Department, Beaujon Hospital, Assistance Publique – Hôpitaux de Paris, France
3   University of Paris, France.
,
Anthony Dohan
3   University of Paris, France.
4   Radiology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Benoit Terris
3   University of Paris, France.
5   Pathology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Stanislas Chaussade
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
3   University of Paris, France.
,
Romain Coriat‡
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Gastroenterology Department, Beaujon Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Maximilien Barret‡
1   Gastroenterology Department, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Gastroenterology Department, Beaujon Hospital, Assistance Publique – Hôpitaux de Paris, France
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Abstract

Duodenal polyps are found in 0.1 % to 0.8 % of all upper endoscopies. Duodenal adenomas account for 10 % to 20 % of these lesions. They can be sporadic or occur in the setting of a hereditary predisposition syndrome, mainly familial adenomatous polyposis. Endoscopy is the cornerstone of management of duodenal adenomas, allowing for diagnosis and treatment, primarily by endoscopic mucosal resection. The endoscopic treatment of duodenal adenomas has a high morbidity, reaching 15 % in a prospective study, consisting of bleeding and perforations, and should therefore be performed in expert centers. The local recurrence rate ranges from 9 % to 37 %, and is maximal for piecemeal resections of lesions > 20 mm. Surgical resection of the duodenum is flawed with major morbidity and considered a rescue procedure in cases of endoscopic treatment failures or severe endoscopic complications such as duodenal perforations. In this paper, we review the existing evidence on endoscopic diagnosis and treatment of non-ampullary duodenal adenomas.



Publication History

Received: 04 May 2021

Accepted after revision: 19 October 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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