Cryoballoon treatment of endoscopically unresectable duodenal adenomas

Figure 1 Successful endoscopic management of a refractory duodenal adenoma using cryoballoon ablation. A: Residual duodenal adenoma with high-grade dysplasia after piecemeal endoscopic mucosal resection and clipping outside the hospital. The clips were firmly attached, allowing the cryoballoon treatment to be performed without needing to remove them; B: Performing cryoballoon treatment; C: A 3-month follow-up demonstrated the spontaneous passage of clips and residual adenoma, which was treated with a repeat cryoballoon; D: At 6 months, repeat biopsies at the erythematous areas showed no residual adenoma. There was also no recurrence on subsequent follow-up endoscopy at 18 months.

Figure 2 Flow diagram of patient outcomes.