Published online Jan 14, 2016. doi: 10.3748/wjg.v22.i2.600
Peer-review started: May 12, 2015
First decision: September 11, 2015
Revised: October 14, 2015
Accepted: November 9, 2015
Article in press: November 9, 2015
Published online: January 14, 2016
Core tip: Duodenal lesions can be categorized as subepithelial or mucosally-based. Endoscopic ultrasonography with fine-needle aspiration aides in the diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are subepithelial lesions that should undergo surgical resection. Non-ampullary and ampullary adenomas and other mucosally-based duodenal lesions are amenable to endoscopic resection. Endoscopic papillectomy is effective at resecting ampullary adenomas but is not without risk. Various forms of endoscopic mucosal resection (cap-assisted, cap-band-assisted, and underwater) enable the resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum.