Published online Aug 7, 2016. doi: 10.3748/wjg.v22.i29.6595
Peer-review started: March 26, 2016
First decision: May 12, 2016
Revised: May 23, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: August 7, 2016
Core tip: The duodenum is the most difficult and risky location for endoscopic treatment in the gastrointestinal tract. The risk of delayed perforation and bleeding is unacceptably high, and it is urgently necessary to establish a management protocol to prevent these serious complications. Prophylactic closure of mucosal defects after endoscopic resection is already known to prevent post-procedure-related complications. Conventional clips are primarily used, although these make it difficult to close the mucosal defect completely. Over-the-scope clips and polyglycolic acid sheets can overcome the disadvantage of conventional clips, and laparoscopic-endoscopic cooperative surgery and endoscopic full-thickness resection hold therapeutic potential for duodenal endoscopic treatment without hazardous complications.