Feasibility of endoscopic submucosal dissection for large (≥3 cm) laterally spreading duodenal tumours involving the papilla: a multicentre retrospective study

Endoscopic submucosal dissection (ESD) is seldom used for large duodenal laterally spreading tumours involving the papilla (L-LST-p) due to technical complexity and high adverse event risk. In a multicentre retrospective pilot series of 18 cases, R0 resection and curative rates were 100% and 94%. Delayed bleeding occurred in six patients (33%), with angiographic embolisation required in two and mild pancreatitis in one (5.6%). Over 16–43 months of follow-up, no local recurrences were observed; however, one of two patients with mucosal cancer developed late liver metastases.