十二指肠零碎EMR

                               
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Piecemeal endoscopic mucosal resection (piecemeal EMR) is used to remove a large villous adenoma in the 3rd portion of the duodenum. Compared to the colon, duodenal EMR is associated with more immediate and delayed bleeding. The risk of immediate and delayed perforation may also be higher. However, surgical resection is typically not an attractive alternative. Duodenal ESD is also possible, but extremely risky as both immediate and delayed perforations are common and often difficult to manage.