Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4708
Peer-review started: May 11, 2020
First decision: May 21, 2020
Revised: June 8, 2020
Accepted: September 8, 2020
Article in press: September 8, 2020
Published online: October 26, 2020
Processing time: 167 Days and 19.3 Hours
Gastric heterotopic pancreas (GHP) is generally asymptomatic and rarely features complications. However, the treatment of complicated GHP is challenging and often requires surgical resection.
This retrospective study describes clinical outcomes in patients who underwent endoscopic submucosal dissection (ESD) for complicated GHP.
This study aimed to investigate the clinical outcomes of ESD as alternative to surgical resection for complicated GHP.
Patients who were diagnosed with complicated GHP were treated conservatively as with general practice for acute pancreatitis. After conservative management for resolving the acute phase of pancreatitis, ESD was performed as definitive treatment for complicated GHP. The clinical features of patients and tumors, procedure-related characteristics, and long-term outcomes were investigated.
All lesions were located in the greater curvature of the antrum. On endoscopic ultrasonography during the pain episode, all lesions were located across the muscularis mucosa, submucosa, and proper muscle layers. The median lesion size was 20 during the pain episode at the time of the diagnosis of complicated GHP, and 15 mm at the time of ESD after conservative treatment. The procedure time ranged from 15-120 min. There were no procedure-related adverse events such as perforation or bleeding. The length of hospital stay after the procedure ranged from 2-4 d. All patients were symptom free during the median follow-up period of 46.0 mo.
When patients with GHP experience recurrent severe acute abdominal pain, complicated GHP should be considered as a differential diagnosis.
Conservative treatment followed by ESD can be a feasible minimally invasive alternative to surgical resection.