Reducing the Risk of Post-ESD Pancreatitis in Periampullary Lesions

Endoscopic submucosal dissection (ESD) for periampullary duodenal lesions is known to be technically challenging. Because of its close proximity to the papilla, this procedure carries a risk of post-procedural pancreatitis. Such complications may arise from mechanical trauma, thermal injury during dissection, or inadvertent obstruction of pancreatic duct outflow during mucosal defect closure.