A case series of symptomatic intraluminal duodenal duplication cysts: presentation, endoscopic therapy, and long-term outcome (with video)

Background: Duodenal duplication cysts are rare congenital anomalies. Symptomatic cases have classically been treated by surgical resection, which can be complex because of the close proximity of the cysts to the papilla. Objective: To describe a series of 8 patients with symptomatic duodenal duplication cysts who were treated endoscopically, with a special focus on the long-term outcome. Design: Retrospective case series. Setting: Three tertiary-care European academic hospitals. Patients: Fight patients, age 8 to 72 years, were treated endoscopically for symptomatic intraluminal duodenal duplication cysts between 1981 and 2006. Seven patients presented with acute pancreatitis, and one patient presented with jaundice. Intervention: Endoscopic incision and marsupialization of the cysts was performed by using a variety of endoscopic tools (needle-knife and regular sphincterotomes, cystotomes, and polypectomy snares). Main Outcome Measurements: Technical success of endoscopic intervention and long-term clinical recurrence of symptoms. Results: No major complications occurred. All patients remained asymptomatic at a median follow-up of 7.3 years. Limitations: Retrospective study; the small number of patients. Conclusions: The endoscopic treatment of symptomatic intraluminal duodenal duplication cysts is a safe and effective technique, with excellent long-term results. it represents a minimally invasive alternative to surgical resection and might be considered the preferred therapeutic modality for these cases.