{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:02:24Z","timestamp":1784847744625,"version":"3.55.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018254","name":"Japanese Foundation for Research and Promotion of Endoscopy","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018254","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background and study aims Duodenal endoscopic submucosal dissection (ESD) is technically challenging and associated with a high risk of adverse events. We evaluated duodenal ESD feasibility using cadaver surgical training (CST) with Thiel-embalmed cadavers.<\/jats:p>\n                  <jats:p>Patients and methods Four Thiel-embalmed cadavers underwent upper gastrointestinal endoscopy, followed by simulated duodenal ESD. Seven endoscopists participated, including three experts and four trainees. The participants completed questionnaires evaluating procedural realism, technical difficulty, and educational value.<\/jats:p>\n                  <jats:p>Results Upper gastrointestinal endoscopy was completed in all four cadavers, and duodenal ESD was conducted on seven simulated lesions. As occasionally encountered in clinical practice, the thin duodenal submucosal layer resulted in perforation in two lesions. The questionnaire responses demonstrated high median scores for procedural realism in upper gastrointestinal endoscopy and duodenal ESD. Participants agreed that CST closely replicated endoscopy in living patients and helped acquire duodenal ESD skills. Although psychological stress related to cadaver handling was reported, all participants expressed willingness to participate in future CST.<\/jats:p>\n                  <jats:p>Conclusions Thiel-embalmed CST preserved the gastrointestinal mucosal architecture and was feasible for upper gastrointestinal endoscopy and duodenal ESD, suggesting its potential as a training model, warranting further validation with objective educational outcome measures.<\/jats:p>","DOI":"10.1055\/a-2904-9474","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:08:18Z","timestamp":1782860898000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Feasibility of Duodenal Endoscopic Submucosal Dissection Training Using Thiel-Embalmed Cadavers"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4071-9653","authenticated-orcid":false,"given":"Keiichi","family":"Hashiguchi","sequence":"additional","affiliation":[{"name":"Nagasaki University Hospital, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Department of Endoscopy"]},{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1933-6984","authenticated-orcid":false,"given":"Maiko","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Histopathology and Cell Biology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Akazawa","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Histopathology and Cell Biology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Inomata-Kawasaki","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Shiota","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Akashi","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moto","family":"Kitayama","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Nagasaki University Hospital, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Medical Education Development Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Nagasaki University Hospital, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Department of Endoscopy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Ohnita","sequence":"additional","affiliation":[{"name":"Inoue Hospital, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunobu","family":"Saiki","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Department of Macroscopic Anatomy"]},{"name":"Nagasaki University School of Medicine, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Center of Cadaver Surgical Training"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Ogami-Takamura","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Department of Macroscopic Anatomy"]},{"name":"Nagasaki University School of Medicine, Japan","place":["Nagasaki, Nagasaki Prefecture"],"department":["Center of Cadaver Surgical Training"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisamitsu","family":"Miyaaki","sequence":"additional","affiliation":[{"name":"Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Prefecture, Japan","place":["Nagasaki"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1080\/0284186X.2016.1182211","article-title":"Trends in incidence, treatment and survival of small bowel adenocarcinomas between 1999 and 2013: a population-based study in the Netherlands","volume":"55","author":"L M Legu\u00e9","year":"2016","journal-title":"Acta Oncol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1111\/jgh.15285","article-title":"The incidence of non-ampullary duodenal cancer in Japan: the first analysis of a national cancer registry","volume":"36","author":"M Yoshida","year":"2021","journal-title":"J Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1055\/a-1640-3236","article-title":"Outcomes of endoscopic resection for superficial duodenal tumors: 10 years\u2019 experience in 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