ASGE DDW Videos from Around the World | 2026-TECHNICAL APPROACH TO ENDOSCOPIC SUBMUCOSAL DISSECTION OF A LARGE DUODENAL PERIAMPULLARY GANGLIOCYTIC PARAGANGLIOMA

TECHNICAL APPROACH TO ENDOSCOPIC SUBMUCOSAL DISSECTION OF A LARGE DUODENAL PERIAMPULLARY GANGLIOCYTIC PARAGANGLIOMA

Video Transcription

Video Summary

A 74-year-old man was found to have a large periampullary duodenal subepithelial lesion. EUS and biopsy suggested a grade I neuroendocrine tumor, but the patient declined surgery because of its risks. The team performed endoscopic submucosal dissection after prophylactic biliary and pancreatic stenting. They used a combination of scissor and needle knives, cap assistance, and clip-and-rubber-band traction to complete en bloc resection safely. Pathology showed a gangliocytic pericanglioma with negative margins and no invasion. The patient recovered well, and follow-up ERCP and PET-CT showed no recurrence.

Asset Subtitle

Endoscopy in Action
Submitted by Dennis Yang

Meta Tag

Concept Gangliocytic Paraganglioma

Concept Duodenal Endoscopic Submucosal Dissection

Concept Periampullary Duodenal Lesion

Concept Neuroendocrine Tumor

Concept Morbidity

Keywords

periampullary duodenal lesion

endoscopic submucosal dissection

gangliocytic pericanglioma

biliary and pancreatic stenting

en bloc resection

Gangliocytic Paraganglioma

Duodenal Endoscopic Submucosal Dissection

Periampullary Duodenal Lesion

Neuroendocrine Tumor

Morbidity