Endoscopic and Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas by Endoscopic Resection

Korean J Gastroenterol. 2020 Jul 25;76(1):9-16. doi: 10.4166/kjg.2020.76.1.9.

Abstract

Backgrounds/aims: Distinguishing gastric ectopic pancreas (GEP) from malignant tumors is relatively difficult. This study evaluated the endosonography findings of pathologically proven GEP.

Methods: Thirty-one patients diagnosed with GEP based on a histopathological analysis from January 2004 to July 2018 were enrolled in this study. All patients underwent EUS and an endoscopic resection.

Results: Seventeen patients were female, and the median age was 41.1 years (range, 14-74). The lesions were localized most commonly in the antrum. The mean size of the GEP was 10.6 mm (range, 7-15). Superficial type lesions, lesions with heterogeneous echogenicity, mixed pattern lesions, and lesions with indistinct borders were commonly observed on EUS. Calcification, anechoic duct-like structures, and thickening of the muscularis propria were observed in some patients. Endoscopic mucosal resection (41.9%) and endoscopic submucosal dissection (58.1%) were performed. The mean procedure time was 22.5 minutes. Complete resection was achieved for 71% of patients. No statistically significant results between the endosonography findings and complete resection rates were obtained. The mean follow-up esophagogastroduodenoscopy duration was 4.5 months. None of the patients presented with residual lesions on subsequent endoscopy.

Conclusions: EUS can help identify the features of GEP. Careful observations of the EUS findings can avoid unnecessary removal of GEP.

Keywords: Accessory pancreas; Endoscopic mucosal resection; Endosonography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Choristoma / diagnostic imaging
  • Choristoma / pathology
  • Choristoma / surgery
  • Endoscopic Mucosal Resection
  • Endoscopy, Gastrointestinal*
  • Endosonography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas / pathology
  • Pyloric Antrum / pathology
  • Stomach / diagnostic imaging
  • Stomach / pathology
  • Stomach Diseases / diagnostic imaging
  • Stomach Diseases / pathology*
  • Stomach Diseases / surgery
  • Young Adult