{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:44:49Z","timestamp":1785303889801,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic submucosal dissection (ESD) in the duodenum is challenging. The water pressure method (WP\u2010ESD) has been developed with a decreased rate of perforation. However, details of perioperative adverse events of WP\u2010ESD are unknown. The purpose of this study was to clarify the frequency and related factors of fecal incontinence and oral regurgitation during WP\u2010ESD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A chart\u2010based retrospective analysis was performed on 43 patients who underwent duodenal WP\u2010ESD. The saline volume given into the body was calculated in all cases. All adverse events during WP\u2010ESD until 6\u2009weeks were extracted, and factors related to intraoperative fecal incontinence or oral regurgitation were analyzed. The frequency of fecal incontinence and oral regurgitation was also compared to those of 83 conventional ESD cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In WP\u2010ESD, intraoperative fecal incontinence occurred in 12 (28%), oral regurgitation in six (14%), and aspiration pneumonia in one patient. For fecal incontinence, the infusion speed (saline volume divided by resection time) around 17\u2009mL\/min was a significant factor in multivariable analysis. For oral regurgitation, only tumor size was a significant factor in univariate analysis (<jats:italic>P<\/jats:italic>\u2009=\u20090.027). Significant difference was observed in the frequency of fecal incontinence between WP\u2010ESD and conventional ESD (28% vs. 0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), but no difference was observed in oral regurgitation or aspiration pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative fecal incontinence is a unique adverse event of WP\u2010ESD related to the infusion speed. WP\u2010ESD did not pose a risk for oral regurgitation, but we should be aware of the risk in large tumor cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14070","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T18:47:47Z","timestamp":1624992467000},"page":"526-534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fecal incontinence and oral regurgitation during duodenal endoscopic submucosal dissection using the water pressure method"],"prefix":"10.1111","volume":"34","author":[{"given":"Yoshihisa","family":"Takada","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine Aichi 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