Fig. 2.

Treatment algorithm of resectable duodenal cancer. Although there is no evidence for additional surgery after local resection of the duodenum, a comprehensive decision an overall decision should be made whether to perform pancreato-duodenectomy plus lymph node dissection, taking into account pathological tumor and patient factors such as vascular invasion and residual cancer. Tis tumor confined to the lamina propria, SM tumor confined to the submucosa, CQ clinical question, EMR endoscopic mucosal resection, CSP cold snare polypectomy, ESD endoscopic submucosal dissection, LECS laparoscopy and endoscopy cooperative surgery, HM horizontal margin, VM vertical margin, EGD esophagogastroduodenoscopy