Nonampullary duodenal polyps: characteristics and endoscopic management.
BACKGROUND
Guidelines for endoscopic resection and surveillance of nonampullary duodenal (NAD) polyps are still not well-defined.


OBJECTIVE
To describe the characteristics of NAD polyps and evaluate the role of endoscopic management.


METHODS
Retrospective review.


METHODS
Tertiary-care academic center.


METHODS
This study involved 59 patients with NAD polyps.


METHODS
Endoscopic polypectomy, biopsy, and argon plasma coagulation.


METHODS
Complete polypectomy, complications, and recurrence.


RESULTS
Ninety-six endoscopies were performed. The mean patient age was 62.8 years. The mean (+/- standard deviation) polyp size was 17.2 mm +/- 1.6 mm. The mean follow-up time was 26 months. Most lesions were sessile, solitary, and located in the descending duodenum. The procedure most often performed was submucosal injection followed by snare polypectomy. Adenomas were found in 68% of lesions overall and in 84% of lesions >2 cm. Successful resection was accomplished in 93% of cases on the initial attempt. Multiple endoscopies were needed in 5% of cases. The overall complete resection rate was 98%. Recurrence was documented in 37% of cases. Complications occurred in 5.2% of patients. Polyps of >2 cm were associated with higher rates of adenoma and a higher incidence of recurrence. Colon adenomas were found in 53% of patients with duodenal adenomas.


CONCLUSIONS
Retrospective review. Not all patients underwent colonoscopy.


CONCLUSIONS
NAD polyps were large, sessile, and more commonly found in the second portion of the duodenum. They are more likely to be adenomatous when the lesion size is >2 cm. Despite successful endoscopic management, over one third of lesions demonstrated recurrence.
Abbass
Rami
R
Division of Gastroenterology, Georgetown University Hospital, Washington, District of Columbia, USA.
Rigaux
Johanne
J
Al-Kawas
Firas H
FH
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004384:Duodenoscopy / Q000379:methods*; D004386:Duodenum / Q000473:pathology / Q000601:surgery; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D007417:Intestinal Polyps / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy; D054020:Lasers, Gas; D008067:Lipoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies