ASGE DDW Videos from Around the World | 2026-ENDOSCOPIC SUBMUCOSAL DISSECTION AND SUTURING OF A LATERAL-SPREADING AMPULLARY LESION

ENDOSCOPIC SUBMUCOSAL DISSECTION AND SUTURING OF A LATERAL-SPREADING AMPULLARY LESION

Video Transcription

Video Summary

A 57-year-old woman with a 4 cm ampullary adenoma underwent endoscopic submucosal dissection (ESD) with ERCP and endoscopic suturing under general anesthesia. Because ampullary ESD is technically difficult and risks bleeding, perforation, and pancreatitis, the team used chromoendoscopy, saline immersion, and clip-rubber band traction to improve visualization and control. After en bloc R0 resection, pancreatic and biliary stents were placed, and the defect was closed with barbed suturing. Histology showed tubulovillous adenoma with high-grade dysplasia. She had only mild pancreatitis, recovered quickly, and had no recurrence at 2 months.

Asset Subtitle

Video Plenary II
Submitted by Faith Aslan

Keywords

ampullary adenoma

endoscopic submucosal dissection

ERCP

high-grade dysplasia

endoscopic suturing