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Non-ampullary duodenal adenoma

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The following summarized guidelines for the evaluation and management of non-ampullary duodenal adenoma are prepared by our editorial team based on guidelines from the European Society of Gastrointestinal Endoscopy (ESGE 2021).


1.Diagnostic procedures

Lower gastrointestinal endoscopy: perform a colonoscopy in patients with duodenal adenoma, if not performed yet.
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  • Upper gastrointestinal endoscopy

  • Biopsy

2.Therapeutic procedures

Endoscopic resection: consider performing endoscopic resection of all duodenal adenomas as progression to invasive carcinoma is highly likely.
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  • Endoscopic ablation

3.Follow-up and surveillance

Endoscopic surveillance: perform endoscopic surveillance 3 months after the index treatment. Perform follow-up endoscopy 1 year later in patients with no recurrence. Adapt the surveillance intervals thereafter to the lesion site, en bloc resection status, and initial histological result.

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  • Management of recurrent disease