Table 4.

Characteristics and indications of endoscopic treatments

Treatment methods	Advantages	Disadvantages	Recommended indications
CSP	Simple, safe, low incidence of complications	Incomplete resection and local recurrence	Lesion size < 6 mm, especially suitable for FAP
EMR (UEMR)	Convenient, relatively low incidence of complications	Relatively low en bloc resection rate	Lesion size ≤ 20 mm
ESD	High en bloc resection rate irrespective of lesion size	High incidence of complications and proficiency requirement	Lesion size > 20 mm
LECS	Less invasive compared to pancreaticoduodenectomy and secure defect closure	Postoperative obstruction and not suitable for lesions adjacent to ampulla	Lesion size > 20 mm and endoscopically unresectable

CSP: cold snare polypectomy; EMR: endoscopic mucosal resection; ESD: endoscopic submucosal dissection; FAP: familial adenomatous polyposis; LECS: laparoscopic endoscopic cooperative surgery; UEMR: underwater EMR.