Korean J Gastrointest Endosc > Volume 31(3); 2005 > Article
Korean Journal of Gastrointestinal Endoscopy 2005;31(3): 166-170.
십이지장 구부를 침범한 조기위암에서 점막절제술
박지현·김동인·방성조·정인두·신정우·박능화·나양원*·서재희·김도하
울산대학교 의과대학 울산대학교병원 내과, *외과, 진단병리과
Endoscopic Mucosal Resection in Early Gastric Cancer Involving Duodenum
Jee Hyun Park, M.D., Dong In Kim, M.D., Sung Jo Bang, M.D., In Du Jeong, M.D., Jung Woo Shin, M.D., Neung Hwa Park, M.D., Yang Won Nah, M.D.*, Jae Hee Suh, M.D. and Do Ha Kim, M.D.
Departments of Internal Medicine, *Surgery and Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
Abstract
It is difficult to perform endoscopic mucosal resection (EMR) in case of early gastric cancer involving duodenal bulb. To achieve complete resection, we applied a new method: that is, EMR with an insulation-tipped diathermic knife (IT knife) was peformed by the retroflexion of endoscope in the bulb. This method was tried in 4 patients. For the antral side of the tumor, EMR was done using a needle knife or IT knife. The duodenal side of the tumor was resected by IT knife with the retroflexion of endoscope in the bulb. The complete resection was performed in 2 patients, an incomplete resection in one patient, and the laparoscopic subtotal gastrectomy was performed in the remaining one patient because reconstruction of partitional resection was very difficult and adenocarcinoma was found to involve the muscularis mucosa. We think that EMR with IT knife by endoscopic retroflexion in the bulb is effective for some cases of early gastric cancer involving the duodenal bulb. (Korean J Gastrointest Endosc 2005;31:166⁣170)
Key Words: Early gastric cancer, Mucosectomy, Duodenal invasion
주요어: 조기위암, 점막절제술, 십이지장 구부 침범
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