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Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
Feb, 2024;36 (2): 215-220.

Underwater clip closure method for mucosal defects after duodenal endoscopic submucosal dissection (with video).

Tsugitaka Ishida, Osamu Dohi, Mayuko Seya, Katsuma Yamauchi, Hayato Fukui, Hajime Miyazaki, Takeshi Yasuda, Takuma Yoshida, Naoto Iwai, Ken Inoue, Naohisa Yoshida, Hideyuki Konishi, Yoshito Itoh
Author Information
  1. Tsugitaka Ishida: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  2. Osamu Dohi: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  3. Mayuko Seya: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  4. Katsuma Yamauchi: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  5. Hayato Fukui: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  6. Hajime Miyazaki: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  7. Takeshi Yasuda: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  8. Takuma Yoshida: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  9. Naoto Iwai: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  10. Ken Inoue: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  11. Naohisa Yoshida: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. ORCID
  12. Hideyuki Konishi: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  13. Yoshito Itoh: Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
PMID: 37983598 DOI: 10.1111/den.14724

Abstract

Conventional clip closure of mucosal defects after duodenal endoscopic submucosal dissection decreases the incidence of delayed adverse events, but may result in incomplete closure, depending on size or location. This study aimed to assess the effectiveness of the underwater clip closure method for complete duodenal defect closure without the difficulties associated with conventional closure methods. We investigated 19 patients with 20 lesions who underwent endoscopic submucosal dissection of the duodenum and subsequent mucosal defect closure in underwater conditions at our facility between February 2021 and January 2022. The success rate of the underwater clip closure method was defined as the complete endoscopic closure of the mucosal defect; a success rate of 100% was achieved. The median resected specimen size was 34.3 mm, the median procedure time for mucosal defect closure was 14 min, and the median number of clips used per patient was 12. No delayed adverse events were observed. The underwater clip closure method is a feasible option for complete closure of mucosal defects, regardless of the size or location of a duodenal endoscopic submucosal dissection.

Keywords

clip closure delayed adverse event early duodenal cancer underwater

References

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MeSH Term

Humans
Endoscopic Mucosal Resection
Duodenum
Wound Closure Techniques
Intestinal Mucosa
Surgical Instruments
Treatment Outcome
Retrospective Studies
Video-Audio Media Journal Article

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