{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:12:09Z","timestamp":1790971929477,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T00:00:00Z","timestamp":1367193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Perforation is a major complication of endoscopic resection for gastrointestinal neoplasms. However, little is known about delayed perforation after endoscopic resection for non\u2010ampullary duodenal neoplasm. The aim of the present study was to investigate the clinical features of delayed perforation after endoscopic resection for non\u2010ampullary duodenal neoplasm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This was a retrospective cohort study conducted in a referral cancer center. A total of 63 patients (41 with adenomas and 22 with carcinomas) underwent endoscopic mucosal resection (<jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content>) or endoscopic submucosal dissection (<jats:styled-content style=\"fixed-case\">ESD<\/jats:styled-content>) from <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 1993 to <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2011. Incidence, outcome, and factors associated with occurrence of delayed perforation were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Delayed perforation occurred in four patients (6.3%). All lesions were located distal to <jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>ater's ampulla. Three of four delayed perforations occurred within 36\u2009h after endoscopic resection. All patients developed retroperitonitis, and two also had retroperitoneal abscesses. Although three patients were cured with conservative management, a long hospital stay was required (28\u2010, 80\u2010, and 81\u2010day hospital stay, respectively). One patient required emergency surgery as a result of panperitonitis. There was, fortunately, no mortality in this series. The significant predictors of delayed perforation were location (distal to <jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>ater's ampulla, <jats:italic>P<\/jats:italic>\u2009=\u20090.007) and resection method (<jats:styled-content style=\"fixed-case\">ESD<\/jats:styled-content> and piecemeal <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content>, <jats:italic>P<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic resection for non\u2010ampullary duodenal neoplasms has a possible risk of morbid complication i.e. delayed perforation, especially in patients with lesions located on the side distal from the ampulla and who are treated with piecemeal <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ESD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12104","type":"journal-article","created":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T09:33:38Z","timestamp":1367228018000},"page":"220-227","source":"Crossref","is-referenced-by-count":160,"title":["Delayed perforation: A hazardous complication of endoscopic resection for non\u2010ampullary duodenal neoplasm"],"prefix":"10.1111","volume":"26","author":[{"given":"Takuya","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  Osaka Japan"},{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriya","family":"Uedo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Higashino","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryu","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Iishi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Disease  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