Authors
Risa Nakamura, Yoshitaka Nawata, Tomoaki Naka, Kimihiro Igarashi, Toru Okuzono, Mareyuki Endo, Tomoki Matsuda
Published in
Clinical journal of gastroenterology. Jul 24, 2026. Epub Jul 24, 2026.
Abstract
We report successful en bloc underwater endoscopic mucosal resection (UEMR) of a lesion involving the minor duodenal papilla. A woman in her 60s presented with a 10-mm depressed lesion in the descending duodenum. White-light imaging and Magnifying endoscopy suggested a tumor involving a minor papilla. Although side-viewing endoscopes are conventionally used for the minor papilla, pre-procedural assessment indicated inadequate maneuverability for this specific lesion (ED-580T; Fujifilm Corporation, Tokyo, Japan). Consequently, we strategically used a forward-viewing dual-channel endoscope (GIF-2TQ260M; Olympus Medical Systems, Tokyo, Japan). Utilizing its right-side instrument channel and independent suction capability provided a direct approach and stable field of view, facilitating precise snaring. Histopathology confirmed a 15 × 13-mm intestinal-type adenoma with negative margins. Given the minor papilla was located at the tumor margin and lacked a luminal orifice, the lesion was diagnosed as a superficial non-ampullary duodenal epithelial tumor (SNADET) secondarily extending to the papilla. Forward-viewing endoscopes are viable alternatives for this region depending on lesion orientation. Furthermore, comprehensive pre-procedural assessment, including evaluation for pancreas divisum, may aid in determining treatment strategies, such as the omission of pancreatic stenting. Strategic, case-specific endoscope selection is paramount for safe therapeutic intervention in this complex anatomical region.
PMID:
42496948
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.
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