{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:09:30Z","timestamp":1790172570036,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to compare the short\u2010term therapeutic outcomes between conventional endoscopic submucosal dissection (C\u2010ESD) and gel immersion ESD (GI\u2010ESD) for superficial non\u2010ampullary duodenal epithelial tumors (SNADETs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on patients with SNADETs who underwent C\u2010ESD or GI\u2010ESD between June 2016 and May 2024. To reduce proficiency bias, the first 50 cases per endoscopist were excluded. C\u2010ESD was performed using a scissor\u2010type knife under CO\n                      <jats:sub>2<\/jats:sub>\n                      insufflation, while GI\u2010ESD was performed using the same knife under gel immersion. Primary outcomes included en bloc and R0 resection rates; secondary outcomes were resection time, adverse events, and inflammatory response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 51 C\u2010ESD and 49 GI\u2010ESD procedures were analyzed. Both groups achieved 100% en bloc resection. R0 resection rates were comparable (C\u2010ESD: 92.6%, GI\u2010ESD: 90.2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.661). Muscle layer exposure was significantly lower in the GI\u2010ESD group (1.9%) than in the C\u2010ESD group (16.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.032). The mean white blood cell count was also significantly lower in the GI\u2010ESD group (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.038). The incidence of adverse events in the C\u2010ESD and GI\u2010ESD groups was 5.6% and 1.9%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.627). However, no cases of perforation or aspiration were observed in the GI\u2010ESD group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GI\u2010ESD is a safe and effective alternative to conventional ESD for SNADETs, offering comparable resection outcomes and low risk of adverse events with a reduced risk of muscle layer exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70157","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T12:38:28Z","timestamp":1751287108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Gel Immersion Endoscopic Submucosal Dissection Using a Scissor\u2010type Knife for Superficial Non\u2010ampullary Duodenal Epithelial Tumors"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0498-0144","authenticated-orcid":false,"given":"Osamu","family":"Dohi","sequence":"first","affiliation":[{"name":"Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Iwai","sequence":"additional","affiliation":[{"name":"Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Fukui","sequence":"additional","affiliation":[{"name":"Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto 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