目的：探讨内镜切除十二指肠肿瘤的疗效和安全性。方法：对2012年10月至2021年12月间15例接受过内镜下十二指肠肿瘤切除治疗的患者进行回顾性调查。调查内容包括：患者的个人资料，肿瘤的发生部位、大小，内镜切除方法，术后病理诊断以及随访情况等。结果：15例患者中，男11例，女4例，年龄32～71岁，平均52岁。十二指肠乳头病变8例（53%），降部（非乳头部位）病变3例，球部病变2例，球部、水平部多发病变1例，降部、水平部多发病变1例。病变最大直径0.6～8.0cm，中位数为1.8cm。内镜手术情况：乳头切除术治疗8例次，内镜黏膜切除术治疗3例次，内镜黏膜下剥离术治疗5例次。内镜操作时间42～161min，中位数为50min。15例病变中，12例（80%）成功于内镜下完全切除；3例内镜下仅部分切除，中转外科开腹手术后完全切除。术后病理证实：腺瘤8例（53%），类癌3例，腺瘤性息肉2例、平滑肌瘤1例，间质瘤1例。成功完成内镜下肿瘤切除治疗的12例患者中，术后出现并发症3例（3%），其中出血2例，穿孔1例，均通过保守治疗成功控制；随访3～60个月，中位数为9个月，1例（8%）于术后2个月复发，再次行内镜下肿瘤切除治疗，术后随访4个月未见异常。结论：短期随访表明，内镜切除十二指肠肿瘤安全、有效。在外科医生的协同配合下，更多的十二指肠肿瘤可以优先尝试通过内镜切除进行治疗，从而减少开腹手术。

关键字：十二指肠肿瘤；内镜切除；术后病理诊断

Abstract：

Objective: To investigate the efficacy and safety of endoscopic resection of duodenal neoplasms. Methods: A retrospective investigation was conducted on 15 patients who underwent endoscopic resection of duodenal tumors from October 2012 to December 2021. The questionnaire included: the patient's personal data, the location and size of the tumor, the method of endoscopic resection, postoperative pathological diagnosis and follow-up. Results: There were 11 males and 4 females with an average age of 52 years (range, 32-71 years). There were 8 cases (53%) of duodenal papilla lesions, 3 cases of descending part (non-papillary part) lesions, 2 cases of bulb lesions, 1 case of multiple lesions in bulb and horizontal part, and 1 case of multiple lesions in descending part and horizontal part. The maximum diameter of the lesions was 0.6-8.0 cm, with a median of 1.8cm. Endoscopic surgery: papillectomy was performed in 8 cases, endoscopic mucosal resection in 3 cases, and endoscopic submucosal dissection in 5 cases. The median endoscopic procedure time was 50min (range 42-161 min). Of the 15 lesions, 12 (80%) were successfully completely resected under endoscopy. Three cases were only partially resected under endoscopy and completely resected after conversion to open surgery. Postoperative pathology confirmed adenoma in 8 cases (53%), carcinoid in 3 cases, adenomatous polyp in 2 cases, leiomyoma in 1 case, and stromal tumor in 1 case. Among the 12 patients who successfully underwent endoscopic tumor resection, 3 patients (3%) had postoperative complications, including 2 cases of bleeding and 1 case of perforation, which were successfully controlled by conservative treatment. The median follow-up time was 9 months (range 3-60 months). One patient (8%) had tumor recurrence 2 months after surgery and underwent endoscopic tumor resection again, and no abnormality was found 4 months after surgery. Conclusions: Endoscopic resection of duodenal neoplasms is safe and effective in short-term follow-up. With a concerted effort by surgeons, more duodenal tumors could be preferentially attempted to be treated by endoscopic resection, resulting in less open surgery.

Keywords: Tumors of the duodenum; Endoscopic resection; Postoperative Pathological diagnosis

目的：探讨内镜切除十二指肠肿瘤的疗效和安全性。方法：对2012年10月至2021年12月间15例接受过内镜下十二指肠肿瘤切除治疗的患者进行回顾性调查。调查内容包括：患者的个人资料，肿瘤的发生部位、大小，内镜切除方法，术后病理诊断以及随访情况等。结果：15例患者中，男11例，女4例，年龄32～71岁，平均52岁。十二指肠乳头病变8例（53%），降部（非乳头部位）病变3例，球部病变2例，球部、水平部多发病变1例，降部、水平部多发病变1例。病变最大直径0.6～8.0cm，中位数为1.8cm。内镜手术情况：乳头切除术治疗8例次，内镜黏膜切除术治疗3例次，内镜黏膜下剥离术治疗5例次。内镜操作时间42～161min，中位数为50min。15例病变中，12例（80%）成功于内镜下完全切除；3例内镜下仅部分切除，中转外科开腹手术后完全切除。术后病理证实：腺瘤8例（53%），类癌3例，腺瘤性息肉2例、平滑肌瘤1例，间质瘤1例。成功完成内镜下肿瘤切除治疗的12例患者中，术后出现并发症3例（3%），其中出血2例，穿孔1例，均通过保守治疗成功控制；随访3～60个月，中位数为9个月，1例（8%）于术后2个月复发，再次行内镜下肿瘤切除治疗，术后随访4个月未见异常。结论：短期随访表明，内镜切除十二指肠肿瘤安全、有效。在外科医生的协同配合下，更多的十二指肠肿瘤可以优先尝试通过内镜切除进行治疗，从而减少开腹手术。

关键词：十二指肠肿瘤；内镜切除；术后病理诊断

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