ENDOSCOPIC RESECTION OF SMALL DUODENAL CARCINOID-TUMORS WITH STRIP BIOPSY TECHNIQUE

Background: Most cases of duodenal carcinoid have conventionally been treated by surgical resection. The aim of our study was to explore the feasibility of endoscopic resection in small duodenal carcinoids. Met hods: The study population consisted of seven patients with small duod enal carcinoids. The diagnosis was confirmed by preoperative biopsies. The depth of tumor invasion was evaluated by endosonography. Results: The carcinoid was detected by endosonography in all cases. Size range d ultrasonographically from 1.5 mm to 7 mm, Tumor invasion was confine d to the submucosa in all patients. Endoscopic resection was performed with the strip biopsy technique using a two-channel endoscope. In six patients, the specimens were resected without severe complications. F ive of them were confirmed histologically to be typical carcinoids. In one patient, carcinoid was not detected histologically in the specime n. In the remaining patient, a perforation occurred. However, the huge ulcer was managed conservatively, Follow-up endoscopy revealed no evi dence of recurrent or residual tumor in any patient. Conclusion: Small duodenal carcinoids confined to the submucosa can be resected endosco pically and preoperative endosonography is necessary for the determina tion of endoscopic resectability.