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. 2021 Oct 31;2(1):e60. doi: 10.1002/deo2.60

TABLE 5.

Major complications and management for preventing them in duodenal endoscopic submucosal dissection (ESD)

Frequency Preventative method
Intraoperative perforation 6.0%–31.6% (emergency surgery was required in 3.1%–23.1% of such cases) 105 , 106 , 107 , 108 , 109

  • The use of the Clutch Cutter 105

  • Pocket‐creation method 106

  • Water pressure method 111

Delayed perforation 1.5%–4.8% 105 , 106 , 107 , 108 , 109 (emergency surgery was required in 25.0%–100.0% of such cases 106 , 107 , 108 , 109 )

  • Mucosal defect closure (clips, clips with string, an endoloop, over‐the‐scope clips) 105 , 112 , 113 , 114

  • Coverage of mucosal defect with a PGA sheet 115 , 116

Delayed bleeding 0.0%–18.4% 105 , 106 , 108 , 109 , 118

  • Mucosal defect closure (clips, clips with string, an endoloop, over‐the‐scope clips) 117

  • Coverage of mucosal defect with PGA sheet 117

  • The use of vonoprazan ≥20 mg/day 34

Abbreviation: PGA, polyglycolic acid.