title: Pancreatic rest resection using band ligation snare polypectomy.
abstract: BACKGROUND
  Although pancreatic rests have characteristic endoscopic features, confirming a histological diagnosis may be desirable to exclude other significant pathology.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy and safety of endoscopic band ligation snare polypectomy (EBLSP) for removal of suspected pancreatic rests and to compare the diagnostic yield to other endoscopic tissue sampling methods.
  
  
  METHODS
  An electronic endoscopic report database was searched for patients referred for evaluation of incidentally found gastric antral subepithelial lesions. Tissue sampling technique, pathology, and complications were recorded.
  
  
  RESULTS
  Removal of suspected pancreatic rests with EBLSP was successful in all 21 cases without complications. Nineteen of 21 (90%) who underwent EBLSP had a histological diagnosis of heterotopic pancreas compared with 5 of 14 (36%) who underwent tissue sampling with biopsy and/or snare (P = 0.001). The endoscopic characteristics of the histology proven pancreatic rests were an antral subepithelial mass with central umbilication measuring 6-10 mm in diameter and located 2-6 cm from the pylorus in the 3-7 o'clock position.
  
  
  CONCLUSIONS
  Endoscopic band ligation snare polypectomy resection of gastric antral lesions suspected to be pancreatic rests had a diagnostic yield superior to standard biopsy forceps and snare polypectomy techniques. However, because all pathologically confirmed pancreatic rests had typical endoscopic appearances of pancreatic rests, it may not be necessary to obtain histologic diagnosis for every suspected gastric antral heterotopic pancreas.
authors: Division of Gastroenterology, University of California, San Diego, San Diego, CA, USA. abain@ucsd.edu
authors: Andrew J
authors: AJ
authors: Bain
authors: David J
authors: DJ
authors: Owens
authors: Raymond S
authors: RS
authors: Tang
authors: Michael R
authors: MR
authors: Peterson
authors: Thomas J
authors: TJ
authors: Savides
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010182:Pancreatic Diseases / Q000151:congenital* / Q000601:surgery*